Eagledancer Youth and Family Services, Inc.

Primary specialty

Emotionally Disturbed Childrens' Residential Treatment FacilityTaxonomy code 322D00000X

Legal business name

EAGLEDANCER YOUTH AND FAMILY SERVICES, INC.

Practice address

305 West Ben Gay
White River, AZ 85941

Phone

(928) 338-2312

Fax

(928) 338-2313

NPI assigned

Sep 25, 2007

Last updated

Mar 15, 2011By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Mrs. Charla C Hatch

Title

Executive Director

Phone

(928) 229-0560

Specialties & licenses 3

Addresses

Tax ID family

Eagledancer Youth and Family Services Inc2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

• Eagledancer Youth and Family Services, Inc.

  • Foster Care Agency
  • Snowflake, AZ
  • NPI 1811295942
  NPD tax ID

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

{
    "created_epoch": "1190678400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1300147200000",
    "number": "1730375668",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1323 LOBO TRL",
            "address_2": "1323 LOBO TRAIL",
            "city": "SNOWFLAKE",
            "state": "AZ",
            "postal_code": "859375407",
            "telephone_number": "928-227-3950"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "305 WEST BEN GAY",
            "city": "WHITE RIVER",
            "state": "AZ",
            "postal_code": "85941",
            "telephone_number": "928-338-2312",
            "fax_number": "928-338-2313"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EAGLEDANCER YOUTH AND FAMILY SERVICES, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-09-25",
        "last_updated": "2011-03-15",
        "status": "A",
        "authorized_official_last_name": "HATCH",
        "authorized_official_first_name": "CHARLA",
        "authorized_official_middle_name": "C",
        "authorized_official_title_or_position": "EXECUTIVE DIRECTOR",
        "authorized_official_telephone_number": "928-229-0560",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "320800000X",
            "taxonomy_group": "",
            "desc": "Community Based Residential Treatment Facility, Mental Illness",
            "state": "AZ",
            "license": null,
            "primary": false
        },
        {
            "code": "322D00000X",
            "taxonomy_group": "",
            "desc": "Residential Treatment Facility, Emotionally Disturbed Children",
            "state": "AZ",
            "license": null,
            "primary": true
        },
        {
            "code": "324500000X",
            "taxonomy_group": "",
            "desc": "Substance Abuse Rehabilitation Facility",
            "state": "AZ",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• DHHS IHS Phoenix Area (Whiteriver Indian Hospital)
• Kerri Dowgiallo, R.N.
• Paul A Drake, ARDMS,ARRT,CNMT
• CJ Duncan, PT, DPT
• Pierre-Alex Duvivier, PHARMD
• Melissa Esquivel
• Carmelita Ruth Estenson, RN, BSN, PHN, LCCE
• Jonathan Douglas Evans, DDS
• Robert T Evans, DPM
• Mark Feltner

• Emotionally Disturbed Childrens' Residential Treatment Facility in Whiteriver, AZ
• Providers in Whiteriver, AZ by specialty
• Emotionally Disturbed Childrens' Residential Treatment Facility in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 15, 2011; 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.