NPI | 1609528272 |
---|---|
Doing Business As | THE HISTORIC BLUE ROSE RECOVERY MANSION |
Other Name | BLUE ROSE DETOX MANSION |
Former Legal Business Name | MIND REPOSE LLC |
Entity Type | Organization |
Authorized Contact | DANIEL CASE CEO 480-300-2655 |
Organization Subpart ? | No |
Primary Taxonomy | 324500000X Substance Abuse Rehabilitation Facility |
Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) |
102L00000X Psychoanalyst | |
103TA0400X Psychologist, Addiction (Substance Use Disorder) | |
103TB0200X Psychologist, Cognitive & Behavioral | |
103TC0700X Psychologist, Clinical | |
103TC1900X Psychologist, Counseling | |
103TP0016X Psychologist, Prescribing (Medical) | |
103TP0814X Psychologist, Psychoanalysis | |
103TP2701X Psychologist, Group Psychotherapy | |
103TR0400X Psychologist, Rehabilitation | |
163WA0400X Registered Nurse, Addiction (Substance Use Disorder) | |
207QA0401X Family Medicine, Addiction Medicine | |
2084A0401X Psychiatry & Neurology, Addiction Medicine | |
261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center) | |
Enumeration Date | 2022-01-25 |
Last Update Date | 2022-01-25 |