Organization
PIA'S PLACE
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. JEFFREY F PENNY M.D. (MEDICAL DIRECTOR)
(928) 445-8400
Entity
Organization
Contact information
Practice address
615 W HILLSIDE AVE, PRESCOTT, AZ 86301-1936
(928) 445-5081
(928) 445-0395
Mailing address
615 W HILLSIDE AVE, PRESCOTT, AZ 86301-1936
(928) 445-5081
(928) 445-0395
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
Primary
BH-922
AZ
Other
Enumeration date
05/14/2009
Last updated
05/14/2009
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