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Organization

LODGE AT SEDONA, LLC

Active
Other names
Sedona Wellness Retreat
Organization subpart
No

Provider details

NPI number
Authorized official
RYAN FERCHOFF N.M.D. (DIRECTOR)
(928) 613-2233
Entity
Organization

Contact information

Practice address
125 KALLOF PL, LODGE AT SEDONA, SEDONA, AZ 86336-5566
(928) 204-1942
(928) 204-2128
Mailing address
125 KALLOF PL, LODGE AT SEDONA, SEDONA, AZ 86336-5566
(928) 204-1942
(928) 204-2128

Taxonomy

Speciality
Code
Description
License number
State
175F00000X
Naturopath
261QH0100X
Health Service Clinic/Center
Primary
261QI0500X
Infusion Therapy Clinic/Center
324500000X
Substance Abuse Rehabilitation Facility

Other

Enumeration date
09/02/2014
Last updated
09/02/2014
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