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Organization
LAKE MONTEZUMA RTC, LLC
Active
Organization
LAKE MONTEZUMA RTC, LLC
Active
Other names
Sedona Sky Academy
Organization subpart
No
Provider details
NPI number
Authorized official
TAMMY BEHRMANN (EXECUTIVE DIRECTOR)
(928) 567-1322
Entity
Organization
Contact information
Practice address
3090 CORONADO TRAIL, RIMROCK, AZ 86335-5283
(928) 567-1322
(928) 567-1323
Mailing address
3090 CORONADO TRAIL, RIMROCK, AZ 86335-5283
(928) 567-1322
(928) 567-1323
Taxonomy
Speciality
Code
Description
License number
State
322D00000X
Emotionally Disturbed Childrens' Residential Treatment Facility
Primary
BH4470
AZ
Other
Enumeration date
04/23/2014
Last updated
04/23/2014
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