Organization
COPPER CACTUS BEHAVIORAL HEALTH LC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
KYONA JESSELL RELF (OWNER)
(480) 930-3646
Entity
Organization
Contact information
Practice address
4715 W MALDONADO RD, LAVEEN, AZ 85339-8214
(480) 930-3646
Mailing address
8437 S 50TH DR, LAVEEN, AZ 85339-2165
(312) 962-9557
Taxonomy
Speciality
Code
Description
License number
State
320800000X
Mental Illness Community Based Residential Treatment Facility
—
—
324500000X
Substance Abuse Rehabilitation Facility
Primary
—
—
Other
Enumeration date
04/27/2021
Last updated
04/27/2021
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