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Organization
R. SMYLY ADDICTION CLINICAL SERVICES LLC
Active
Organization
R. SMYLY ADDICTION CLINICAL SERVICES LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MATT LUCHINI (ACCOUNT MANAGER)
(928) 533-4220
Entity
Organization
Contact information
Practice address
819 W GURLEY ST UNIT C, PRESCOTT, AZ 86305-3626
(928) 671-1443
Mailing address
819 W GURLEY ST UNIT C, PRESCOTT, AZ 86305-3626
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
—
—
101YM0800X
Mental Health Counselor
—
—
Other
Enumeration date
02/06/2014
Last updated
02/06/2014
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