Provider Demographics
NPI:1891567293
Name:OAK CREEK PSYCHIATRIC MENTAL HEALTH NP PLLC
Entity Type:Organization
Organization Name:OAK CREEK PSYCHIATRIC MENTAL HEALTH NP PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/PROVIDER
Authorized Official - Prefix:
Authorized Official - First Name:CYBELE
Authorized Official - Middle Name:
Authorized Official - Last Name:SAIMO
Authorized Official - Suffix:
Authorized Official - Credentials:PMHNP-BC
Authorized Official - Phone:928-910-2121
Mailing Address - Street 1:PO BOX 525
Mailing Address - Street 2:
Mailing Address - City:CORNVILLE
Mailing Address - State:AZ
Mailing Address - Zip Code:86325-0525
Mailing Address - Country:US
Mailing Address - Phone:928-910-2127
Mailing Address - Fax:
Practice Address - Street 1:799 COVE PKWY
Practice Address - Street 2:
Practice Address - City:COTTONWOOD
Practice Address - State:AZ
Practice Address - Zip Code:86326-4683
Practice Address - Country:US
Practice Address - Phone:928-910-2127
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-10-27
Last Update Date:2024-04-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM1300XAmbulatory Health Care FacilitiesClinic/CenterMulti-Specialty