| NPI | 1780777540 |
|---|---|
| Former Legal Business Name | SEQUELCARE OF ARIZONA, LLC DBA PRESCOTT HOUSE |
| Entity Type | Organization |
| Authorized Contact | BROOKE WILSON Senior Credentialing Specialist 928-910-7644 |
| Organization Subpart ? | No |
| Primary Taxonomy | 320800000X Community Based Residential Treatment Facility, Mental Illness (Licence: AZ BH-3650) |
| Enumeration Date | 2006-10-02 |
| Last Update Date | 2022-07-06 |