| NPI | 1952962607 |
|---|---|
| Doing Business As | PRESTIGE RECOVERY RETREAT |
| Entity Type | Organization |
| Authorized Contact | CASSANDRA FORTSON Managing Member 480-868-8697 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 324500000X Substance Abuse Rehabilitation Facility |
| Additional Taxonomies | 323P00000X Psychiatric Residential Treatment Facility |
| Enumeration Date | 2019-06-24 |
| Last Update Date | 2024-11-13 |