Main Street Diagnostic LLC

NPI #1225027477 in Cottonwood, Arizona

Provider Information

NPI Number
1225027477
Entity Type
Organization
Organization Name
Main Street Diagnostic LLC
Primary Specialty
Psychiatric Hospital
Enumeration Date
Oct 20, 2005
Last Updated
Aug 22, 2020

Practice Location

Address
636 N MAIN ST
State
Arizona
ZIP Code
86326-3725
Phone
(928) 639-4440

Authorized Official

Name
MARIA CARRILLO
Title
FINANCE COORDINATOR
Phone
(928) 639-4440

Specialties & Taxonomy Codes

Specialty
Psychiatric Hospital

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