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General NPI Number Information
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NPI Number | 1417033630
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Entity Type | Organization
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Legal Business Name | YUMA TREATMENT CENTER LLC
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Dates
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Enumeration Date | 10/31/2006
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Last Update Date | 03/07/2023
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Provider Practice Location Address
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Address Line | 1290 W 8TH PLACE YUMA TREATMENT CENTER
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City | YUMA
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State | AZ
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Zip | 85364
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Country | US
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Telephone | 928-344-4310
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Fax | 928-344-4366
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Provider Business Mailing Address
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Address Line | 19401 N CAVE CREEK ROAD #18 ADMINISTRATIVE OFFICE
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City | PHOENIX
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State | AZ
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Zip | 85024-1825
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Country | US
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Telephone | 602-996-0105
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Fax | 602-996-1915
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Authorized Official
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Title or Position | REGIONAL COORDINATOR
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Name | DEBI MCKINNEY
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Credential |
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Telephone | 602-996-0105
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251S00000X
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Taxonomy Name | Community/Behavioral Health Agency
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License Number | BH2472
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License Number State | AZ
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