DHEW IND HLTH SV HLTH SVS & MNTL HLTH ADM (NPI# 1962949008) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1962949008 |
| Entity Type | Organization |
| Organization Name | DHEW IND HLTH SV HLTH SVS & MNTL HLTH ADM |
| Other Organization Name | SAN LUCY CLINIC |
| Practice Address |
1216 N. 307th Avenue San Lucy Clinic Gila Bend AZ 85337 |
| Mailing Address |
San Lucy Clinic P.o.box 31001-0698 Pasadena CA 91110-0698 |
| Practice Telephone | 9286832913 |
| Practice Fax Number | 9286832008 |
| Mailing Telephone | 6022631200 |
| Mailing Fax Number | 6022631618 |
| Enumeration Date | 2017-01-27 |
| Last Update Date | 2019-06-19 |
| Authorized Official Name | MISS DEANNA J. DICK ((CEO) CHIEF EXECUTIVE OFFICER) |
| Authorized Official Telephone | 6022631567 |
| Authorized Official Credential | MSW,. MHA |
| Is Organization Subpart | Y |
| Parent Organization Name | DHEW IND HLTH SV HLTH SVS & MNTL HLTH ADM |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 251K00000X | Public Health or Welfare | Agencies |
| Other Name | Type Code |
|---|---|
| San Lucy Clinic | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1932360054 | Dhew Ind Hlth Sv Hlth Svs & Mntl Hlth Adm | Dentist | 6822 E 1000 South, Fort Duchesne, UT 84026 | 2008-06-20 |
| 1205859618 | Dhew Ind Hlth Sv Hlth Svs & Mntl Hlth Adm | Public Health or Welfare | 2121 West Reservation Loop Road, Camp Verde, AZ 86322 | 2006-07-26 |
| 1619377942 | Dhew Ind Hlth Sv Hlth Svs & Mntl Hlth Adm | Clinic/Center | 9010 Magnolia Ave, Riverside, CA 92503-4431 | 2014-08-22 |
| 1003083551 | Dhew Ind Hlth Sv Hlth Svs & Mntl Hlth Adm | Clinic/Center | 4212 North 16th Street, Phoenix Indian Medical Center Ambulatory Surgical Cent, Phoenix, AZ 85016-5319 | 2008-05-14 |
| 1831245661 | Dhew Ind Hlth Sv Hlth Svs & Mntl Hlth Adm | Psychologist | 100 North Gila Boulevard, Gila Bend, AZ 85227-2658 | 2007-01-26 |
| 1831244169 | Dhew Ind Hlth Sv Hlth Svs & Mntl Hlth Adm | Psychologist | 2121 West Reservation Loop Road, Camp Verde, AZ 86322 | 2007-01-25 |
| 1578618831 | Dhew Ind Hlth Sv Hlth Svs & Mntl Hlth Adm | Dentist | 2121 West Reservation Loop Road, Camp Verde, AZ 86322-8412 | 2007-01-24 |
| 1679628531 | Dhew Ind Hlth Sv Hlth Svs & Mntl Hlth Adm | Family Medicine | 10005 E Osborn Rd, Scottsdale, AZ 85256-4019 | 2007-01-23 |
| 1730255639 | Dhew Ind Hlth Sv Hlth Svs & Mntl Hlth Adm | Durable Medical Equipment & Medical Supplies | 10005 E Osborn Rd, Scottsdale, AZ 85256-4019 | 2006-11-24 |
| 1932274214 | Dhew Ind Hlth Sv Hlth Svs & Mntl Hlth Adm | Dentist | 10005 E Osborn Rd, Scottsdale, AZ 85256-4019 | 2006-11-21 |
| Street Address |
1216 N. 307TH AVENUE SAN LUCY CLINIC |
| City | GILA BEND |
| State | AZ |
| Zip Code | 85337 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1629562285 | Christopher Ferschke | Nurse Practitioner | 100 N Gila Blvd, Gila Bend, AZ 85337 | 2018-06-18 |
| 1396009809 | Whitney Raser | Specialist/Technologist | 308 N. Martin Avenue, Gila Bend, AZ 85337 | 2012-06-28 |
| 1750589974 | Terez Jamille Getz | Family Medicine | 100 N. Gila Ave, Gila Bend, AZ 85337 | 2007-07-10 |
| 1619954914 | Town of Gila Bend | Ambulance | 644 W Pima, Gila Bend, AZ 85337 | 2005-12-28 |
| 1215114723 | County of Maricopa - Maricopa County School Dist 24 | Local Education Agency (LEA) | 308 N. Martin Ave, Box V, Gila Bend, AZ 85337-0420 | 2008-01-28 |
| 1386702942 | Adelante Healthcare, Inc. | Family Medicine | 100 North Gila Blvd., Gila Bend, AZ 85337-0480 | 2006-12-05 |
| 1912921677 | Dhew Ind Hlth Sv Hlth Svs & Mntl Hlth | Public Health or Welfare | 100 North Gila Boulvard, Gila Bend, AZ 85337-2658 | 2006-07-27 |
| 1952736159 | Michelle Gavura | Specialist | 7208 E. Cave Creek Rd, Carefree, AZ 85337-5924 | 2013-09-06 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1952533556 | Sun Valley Pharmacy LLC | Pharmacy | 219 W Pima, Gila Bend, AZ 85353 | 2009-08-14 |
| 1780730549 | Dhew Indian Health Service Health Services & Mental Health Adm. | Dentist | 100 North Gila Boulevard, Gila Bend, AZ 85227-2658 | 2007-01-26 |
| 1831245661 | Dhew Ind Hlth Sv Hlth Svs & Mntl Hlth Adm | Psychologist | 100 North Gila Boulevard, Gila Bend, AZ 85227-2658 | 2007-01-26 |
| Taxonomy Code | 251K00000X |
| Grouping | Agencies |
| Classification | Public Health or Welfare |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1912921677 | Dhew Ind Hlth Sv Hlth Svs & Mntl Hlth | Public Health or Welfare | 100 North Gila Boulvard, Gila Bend, AZ 85337-2658 | 2006-07-27 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.