Organization
ARROWHEAD LODGE
Active
Parent organization
THE MONTANA SOCIETY
Organization subpart
Yes
Provider details
NPI number
Legal business name
THE MONTANA SOCIETY
Authorized official
KENNETH ANTHONY GRAY LCSW (INSURANCE COORDINATOR)
(626) 797-9977
Entity
Organization
Contact information
Practice address
5113 W ARROWHEAD DR, PRESCOTT, AZ 86305-7304
(626) 797-9977
Mailing address
5113 W ARROWHEAD DR, PRESCOTT, AZ 86305-7304
Taxonomy
Speciality
Code
Description
License number
State
324500000X
Substance Abuse Rehabilitation Facility
Primary
BH-3965
AZ
Other
Enumeration date
06/29/2012
Last updated
06/29/2012
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