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Organization
COPPER CANYON ACADEMY
Active
Organization
COPPER CANYON ACADEMY
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MICHAEL GURR (PROGRAM DIRECTOR)
(928) 567-1322
Entity
Organization
Contact information
Practice address
3090 CORONADO TRAIL, RIMROCK, AZ 86335
(928) 567-1322
Mailing address
3095 CORONADO TRAIL, RIMROCK, AZ 86335
Taxonomy
Speciality
Code
Description
License number
State
322D00000X
Emotionally Disturbed Childrens' Residential Treatment Facility
Primary
LPC12646
AZ
Other
Enumeration date
12/17/2012
Last updated
12/17/2012
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