Sequel Tsi of Az, LLC

NPI #1982934618 in Kayenta, Arizona

Provider Information

NPI Number: 1982934618
Entity Type: Organization
Organization Name: Sequel Tsi of Az, LLC
Subpart: Yes (part of a larger organization)
Parent Organization: SEQUELCARE OF AZ, LLC
Primary Specialty: Clinic/Center - Adult Mental Health
Enumeration Date: Dec 31, 2009
Last Updated: Dec 31, 2009

Practice Location

Address: HIGHWAY 163
Address 2: KAYENTA MOBILE HOME PARK #8
City: Kayenta
State: Arizona
ZIP Code: 86033
Phone: (928) 697-3154

Authorized Official

Name: CHRIS BANKEN
Title: EXECUTIVE DIRECTOR
Phone: (602) 335-2095

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Clinic/Center - Adult Mental Health — Adult Mental Health	261QM0850X	Primary

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