Organization
PRONGHORN PSYCHIATRY
Active
Other names
Stoneridge Centers for Brain and Addiction Treatment
Organization subpart
No
Provider details
NPI number
Authorized official
JOSEPH LETENDRE (CHIEF EXECUTIVE OFFICER)
(928) 583-7799
Entity
Organization
Contact information
Practice address
5940 E. COPPER HILL DR, SUITE E, PRESCOTT VALLEY, AZ 86314
(928) 583-7799
(928) 583-7891
Mailing address
5940 E. COPPER HILL DR, SUITE E, PRESCOTT VALLEY, AZ 86314
(928) 583-7799
(928) 583-7891
Taxonomy
Speciality
Code
Description
License number
State
261QM0850X
Adult Mental Health Clinic/Center
Primary
OTC8169
AZ
291U00000X
Clinical Medical Laboratory
—
—
Other
Enumeration date
05/23/2018
Last updated
11/15/2024
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