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Organization
COPPER CANYON ACADEMY
Active
Organization
COPPER CANYON ACADEMY
Active
Organization subpart
No
Provider details
NPI number
Authorized official
TRACY EDWARDS (EXECUTIVE DIRECTOR)
(928) 567-1322
Entity
Organization
Contact information
Practice address
3090 CORONADO TRAIL, RIMROCK, AZ 86335
(928) 567-1322
(928) 567-1323
Mailing address
PO BOX 230, RIMROCK, AZ 86335
(928) 567-1322
(928) 567-1323
Taxonomy
Speciality
Code
Description
License number
State
322D00000X
Emotionally Disturbed Childrens' Residential Treatment Facility
Primary
—
—
Other
Enumeration date
04/28/2009
Last updated
01/21/2014
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