Organization
PRESCOTT ADDICTION RECOVERY CENTER LLC
Active
Other names
PARC
Organization subpart
No
Provider details
NPI number
Authorized official
KENNETH CHANCE D. DIV. (VICE PRESIDENT)
(928) 227-2448
Entity
Organization
Contact information
Practice address
1630 SHOUP ST, SUITE B, PRESCOTT, AZ 86305-1343
(928) 227-2448
Mailing address
1630 SHOUP ST, SUITE B, PRESCOTT, AZ 86305-1343
(928) 227-2448
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
Primary
OTC7711
AZ
Other
Enumeration date
08/03/2016
Last updated
08/03/2016
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