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General NPI Number Information
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NPI Number | 1932274180
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Entity Type | Organization
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Legal Business Name | COLORADO RIVER BEHAVIORAL HEALTH SYSTEM
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Dates
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Enumeration Date | 11/22/2006
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Last Update Date | 08/02/2024
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Provider Practice Location Address
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Address Line | 1340 S 4TH AVE
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City | YUMA
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State | AZ
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Zip | 85364-4626
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Country | US
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Telephone | 641-494-8110
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Fax | 928-782-5701
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Provider Business Mailing Address
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Address Line | 1340 S 4TH AVE
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City | YUMA
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State | AZ
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Zip | 85364-4626
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Country | US
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Telephone | 928-261-8668
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Fax | 928-782-5701
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Authorized Official
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Title or Position | EXECUTIVE
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Name | BROOKE ANNE KEITH
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Credential |
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Telephone | 305-720-9249
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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 | CSA08ADHS0202
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License Number State | AZ
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