Pinetop Treatment Center LLC

Primary specialty

Mental Health Clinic/Center (Including Community Mental Health Center)Taxonomy code 261QM0801X

Legal business name

PINETOP TREATMENT CENTER LLC

Practice address

674 E White Mountain Blvd Suite 1
Pinetop, AZ 85935-8503

Phone

(602) 516-4473

NPI assigned

Apr 14, 2023

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Habtom H Hadish

Title

Manager

Phone

(602) 516-4473

Specialties & licenses 1

Addresses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1681430400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1681430400000",
    "number": "1568158301",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 2310",
            "city": "PINETOP",
            "state": "AZ",
            "postal_code": "859352310",
            "telephone_number": "602-516-4473"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "674 E WHITE MOUNTAIN BLVD SUITE 1",
            "city": "PINETOP",
            "state": "AZ",
            "postal_code": "859358503",
            "telephone_number": "602-516-4473"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PINETOP TREATMENT CENTER LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-04-14",
        "last_updated": "2023-04-14",
        "certification_date": "2023-04-10",
        "status": "A",
        "authorized_official_last_name": "HADISH",
        "authorized_official_first_name": "HABTOM",
        "authorized_official_middle_name": "H",
        "authorized_official_title_or_position": "MANAGER",
        "authorized_official_telephone_number": "602-516-4473"
    },
    "taxonomies": [
        {
            "code": "261QM0801X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Mental Health (Including Community Mental Health Center)",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Morada Behavioral Health Center
• Mayra Patricia Morales
• Thomas Samuel Paxman, DO
• Pinetop Behavioral Health LLC
• Pinetop Medical Associates LTD (Blue Ridge Regional Clinic)
• Pinetop Volunteer Fire District
• R Alan Lee OD PC
• Patricia M Rafferty, OTR/L
• Re Centers of Arizona Inc
• Regina Ross, MD, PC

• Mental Health Clinic/Center (Including Community Mental Health Center) in Pinetop, AZ
• Providers in Pinetop, AZ by specialty
• Mental Health Clinic/Center (Including Community Mental Health Center) in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 14, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.