NPI | 1922190958 |
---|---|
Former Legal Business Name | DAYBREAK BEHAVIORAL RESOURCES DBA BLUE RIDGE MANOR |
Entity Type | Organization |
Authorized Contact | BROOKE WILSON Senior Credentialing Specialist 928-910-7644 |
Organization Subpart ? | Yes |
Primary Taxonomy | 322D00000X Residential Treatment Facility, Emotionally Disturbed Children (Licence: AZ BH-2374) |
Enumeration Date | 2006-09-28 |
Last Update Date | 2022-07-06 |