| NPI | 1356147128 |
|---|---|
| Former Legal Business Name | COUNTRY HEALH CARE |
| Entity Type | Organization |
| Authorized Contact | KENNETH SEAN COUNTRYMAN President 602-363-2743 |
| Organization Subpart ? | No |
| Primary Taxonomy | 3245S0500X Substance Abuse Rehabilitation Facility, Substance Abuse Treatment, Children |
| Additional Taxonomies | 1041C0700X Social Worker, Clinical |
| Enumeration Date | 2025-02-21 |
| Last Update Date | 2025-02-21 |