Provider Demographics
NPI:1922455013
Name:HOPI HEALTH CARE CENTER
Entity Type:Organization
Organization Name:HOPI HEALTH CARE CENTER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:RN ASCN
Authorized Official - Prefix:MS
Authorized Official - First Name:SUSAN
Authorized Official - Middle Name:J
Authorized Official - Last Name:DEYOE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:928-737-6372
Mailing Address - Street 1:HWY 264 MILEPOST 388
Mailing Address - Street 2:
Mailing Address - City:POLACCA
Mailing Address - State:AZ
Mailing Address - Zip Code:86042
Mailing Address - Country:US
Mailing Address - Phone:928-737-8000
Mailing Address - Fax:
Practice Address - Street 1:HWY 264
Practice Address - Street 2:MP 388
Practice Address - City:POLACCA
Practice Address - State:AZ
Practice Address - Zip Code:86042
Practice Address - Country:US
Practice Address - Phone:928-737-8000
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-05-18
Last Update Date:2016-05-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZRN189558282NR1301X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes282NR1301XHospitalsGeneral Acute Care HospitalRural