Organization
PRESCOTT DETOX CENTER, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. ROBERT ASHBY MD (MEDICAL DIRECTOR)
(480) 991-0280
Entity
Organization
Contact information
Practice address
831 GAIL GARDNER WAY, PRESCOTT, AZ 86305-1606
(928) 445-3834
(928) 445-3649
Mailing address
831 GAIL GARDNER WAY, PRESCOTT, AZ 86305-1606
(928) 445-3834
(928) 445-3649
Taxonomy
Speciality
Code
Description
License number
State
276400000X
Substance Use Disorder Rehabilitation Hospital Unit
Primary
BH4207
AZ
Other
Enumeration date
04/23/2013
Last updated
04/23/2013
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