Gonzales, Eugene

Gonzales, Eugene is an individual health care provider with primary practice located at 105 N 5Th Ave , Holbrook AZ 86025-2817. He recently has 2 registered licenses in different health care specialties including Behavioral Health & Social Service Providers / Addiction (Substance Use Disorder), Other Service Providers / Specialist. Behavioral Health & Social Service Providers / Addiction (Substance Use Disorder) is his primary health care specialty. Gonzales, Eugene can be contacted via phone (928) 524-6126.

Contact Information

Primary practice address
105 N 5Th Ave Holbrook AZ 86025-2817
Phone: (928) 524-6126
Fax: (928) 524-6090
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / Addiction (Substance Use Disorder) 101YA0400X LISAC-1244 Arizona
Other Service Providers / Specialist 174400000X 256 Arizona

Profile Details

NPI number 1811035751
LBN Legal business name Gonzales, Eugene
Credentials
Entity Individual
Sole proprietor 1 No
Enumeration date Feb 2nd, 2007
Last updated Jul 8th, 2007 - about 18 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1811035751 NPPES
Arizona Other 167332 AHCCCS

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