# BRIGHTER HEIGHTS ARIZONA, LLC DBA SMOKI TRAIL

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- **Entity:** Organization
- **Status:** Active
- **Parent organization:** BRIGHTER HEIGHTS ARIZONA, LLC
- **Other names:** SequelCare of Arizona, LLC dba Smoki Trail
- **Organization subpart:** Yes

## Provider details

- **NPI number:** 1588740930
- **Legal business name:** BRIGHTER HEIGHTS ARIZONA, LLC
- **Authorized official:** MS. BROOKE WILSON (SENIOR CREDENTIALING SPECIALIST)
- **Authorized official phone:** (928) 910-7644

## Contact information

- **Practice address:** 9435 E SMOKI TRAIL, DEWEY, AZ 86327-6990
- **Practice address phone:** (928) 632-5806
- **Mailing address:** 2517 N GREAT WESTERN DR., SUITE P, PRESCOTT VALLEY, AZ 86314-2597
- **Mailing address phone:** (928) 777-3280
- **Mailing address fax:** (928) 227-8493

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 322D00000X | Emotionally Disturbed Childrens' Residential Treatment Facility | BH-2163 | AZ | Yes |

## Other

- **Enumeration date:** 10/28/2006
- **Last updated:** 07/06/2022

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 01 | — | 717407 | AHCCCS ID | AZ |
| 05 | — | 717407 | — | AZ |