Organization
AMERICAN EAGLE BEHAVIORAL HEALTH AGENCY
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ADAM HANSEN (ADMINISTRATOR)
(926) 271-5550
Entity
Organization
Contact information
Practice address
3536 W VENUS DR, SOMERTON, AZ 85350-7245
(928) 271-5550
Mailing address
1300 S 5TH AVE, YUMA, AZ 85364-4607
Taxonomy
Speciality
Code
Description
License number
State
322D00000X
Emotionally Disturbed Childrens' Residential Treatment Facility
Primary
BH-3409
AZ
Other
Enumeration date
10/02/2009
Last updated
10/02/2009
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