Organization
COUNTRY HEALTH CARE
Active
Other names
Country healh care
Organization subpart
No
Provider details
NPI number
Authorized official
MR. KENNETH SEAN COUNTRYMAN JD (PRESIDENT)
(602) 363-2743
Entity
Organization
Contact information
Practice address
4444 N 25TH ST UNIT 43, PHOENIX, AZ 85016-5645
(602) 363-2743
Mailing address
PO BOX 11077, TEMPE, AZ 85284-0018
(602) 363-2743
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
—
—
3245S0500X
Children's Substance Abuse Rehabilitation Facility
Primary
—
—
Other
Enumeration date
02/21/2025
Last updated
02/21/2025
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