NPIMap

Guidance Center Inc

Organization Active NPI Community/Behavioral Health Agency · Flagstaff, AZ

NPI 1679563290 · NPPES record last updated Aug 22, 2022

Key facts

NPI
1679563290
Entity type
Organization (NPI type 2)
Primary specialty
Community/Behavioral Health Agency 251S00000X
License
OTC6088 (AZ)
Legal business name
GUIDANCE CENTER INC
Practice address
2187 N Vickey St
Flagstaff, AZ 86004-6106
Phone
(928) 714-6409
Fax
(928) 714-6480
NPI assigned
Oct 25, 2005
Organization subpart
No

Authorized official

Name
Mrs. Devon Forrest
Title
Ceo
Phone
(928) 527-1899

Other NPIs on the same Medicare enrollment 3

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

Practitioners 39

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

View all 39

Medicare Care Compare: Hospital

Listed as
The Guidance Center CCN 034023
Type
Psychiatric
Ownership
Voluntary non-profit - Private
Medicare certification status
Active (Provider of Services file)
Emergency services
No

Source: Medicare Care Compare.

Medicare participation

Medicare fee-for-service enrollment
Enrolled (2 enrollments) in AZ

Hospital certification: CCN 034023

Legal name
GUIDANCE CENTER, INC.
Certification status
Active
Provider type (POS)
Hospital – Psychiatric
Participating since
Jun 18, 2001
Last certification
Oct 10, 2017
Beds
16
Ownership / control type
Private (not for profit)
Organization structure
Corporation · Non-profit
Incorporated
May 19, 1969 in AZ
Enrollment address
2187 N Vickey St
Flagstaff, AZ 86004-6121
Hospital subgroups
Psychiatric

All disclosed owners & managing parties 8

As disclosed on the Medicare enrollment (CMS All Owners files). Individuals include officers, directors and managing employees, who may not hold ownership.

NameRoleSinceShare
Kerry Blume
Individual 		Corporate Director
Director		 Aug 27, 2018
Devon Forrest
Individual 		Corporate Officer
Ceo		 Mar 19, 2022
Angela D. Hernandez
Individual 		W-2 Managing Employee
Member Services Manager		 Aug 27, 2018
Nathan Jones
Individual 		Corporate Officer
Secretary		 Aug 27, 2018
Corporate Director
Secretary		 Aug 27, 2018
Judith Marfechuk
Individual 		Corporate Officer
Treasurer		 Aug 27, 2018
Corporate Director
Treasurer		 Aug 27, 2018
Jon T Perez
Individual 		Corporate Officer
President		 Oct 1, 2019
Corporate Director
President		 Oct 1, 2019
Beth Otterstein
Individual 		Corporate Director
Director		 Aug 27, 2018
The Narbha Institute Inc
Organization · Flagstaff, AZ
Corporation, Non-profit 		Operational/Managerial Control Aug 27, 2018 100%

Medicare enrollment records

Enrollment IDStateProvider typePAC IDDetails
O20031013000032 AZ Part a Provider - Hospital 0143132076 1 other NPI on this enrollment
Practice locations: Flagstaff, AZ
O20040624000797 AZ Part B Supplier - Clinic/Group Practice 0143132076 Receives reassigned benefits from 36 practitioners
2 other NPIs on this enrollment
Practice locations: Flagstaff, AZ; Williams, AZ

National Provider Directory

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Community/Behavioral Health Agency 251S00000X OTC6088 AZ Yes
Primary Care Clinic/Center 261QP2300X

Addresses

Primary practice location

2187 N Vickey St
Flagstaff, AZ 86004-6106

Mailing address

2187 N Vickey St
Flagstaff, AZ 86004-6106
Phone (928) 714-6409

Other identifiers

IdentifierTypeStateIssuer
106944MedicaidAZ

Other names

  • The Guidance Center, Inc. Doing business as

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API JSON format, last updated by the provider on Aug 22, 2022.

{
    "created_epoch": "1130198400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1661126400000",
    "number": "1679563290",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2187 N VICKEY ST",
            "city": "FLAGSTAFF",
            "state": "AZ",
            "postal_code": "860046106",
            "telephone_number": "928-714-6409",
            "fax_number": "928-714-6480"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2187 N VICKEY ST",
            "city": "FLAGSTAFF",
            "state": "AZ",
            "postal_code": "860046106",
            "telephone_number": "928-714-6409",
            "fax_number": "928-714-6480"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GUIDANCE CENTER INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-10-25",
        "last_updated": "2022-08-22",
        "certification_date": "2022-08-22",
        "status": "A",
        "authorized_official_last_name": "FORREST",
        "authorized_official_first_name": "DEVON",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "928-527-1899",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": "AZ",
            "license": "OTC6088",
            "primary": true
        },
        {
            "code": "261QP2300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Primary Care",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "106944",
            "state": "AZ"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "The Guidance Center, Inc.",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Flagstaff, AZ

All providers in Flagstaff, AZ · Community/Behavioral Health Agency in Arizona

Sources for this page

Verify at the official NPI Registry.