| NPI | 1346766953 |
|---|---|
| Doing Business As | CANYON STATE ACADEMY |
| Entity Type | Organization |
| Authorized Contact | RUSTY E. ALEXANDER Business Managing Director 775-392-2639 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 322D00000X Residential Treatment Facility, Emotionally Disturbed Children |
| Additional Taxonomies | 261QM0855X Clinic/Center, Adolescent and Children Mental Health (Licence: AZ CSLG6685) |
| Enumeration Date | 2017-08-15 |
| Last Update Date | 2024-03-15 |