Provider Demographics
NPI:1831363175
Name:NAVAJO TREATMENT CENTER FOR CHILDREN AND THEIR FAMILIES
Entity type:Organization
Organization Name:NAVAJO TREATMENT CENTER FOR CHILDREN AND THEIR FAMILIES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CLINICAL DIRECTOR
Authorized Official - Prefix:MS
Authorized Official - First Name:MARGARET
Authorized Official - Middle Name:
Authorized Official - Last Name:SCHILDT
Authorized Official - Suffix:
Authorized Official - Credentials:LISW/LADAC
Authorized Official - Phone:928-871-6818
Mailing Address - Street 1:PO BOX 1967
Mailing Address - Street 2:
Mailing Address - City:WINDOW ROCK
Mailing Address - State:AZ
Mailing Address - Zip Code:86515-1967
Mailing Address - Country:US
Mailing Address - Phone:928-871-7673
Mailing Address - Fax:
Practice Address - Street 1:48 WEST HIGHWAY 264
Practice Address - Street 2:SUITE 244
Practice Address - City:WINDOW ROCK
Practice Address - State:AZ
Practice Address - Zip Code:86515
Practice Address - Country:US
Practice Address - Phone:928-871-7673
Practice Address - Fax:928-871-6176
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-04-17
Last Update Date:2008-04-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NMI3774261QM0855X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0855XAmbulatory Health Care FacilitiesClinic/CenterAdolescent and Children Mental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZ822941Medicaid