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Organization

BRIGHTER HEIGHTS ARIZONA, LLC DBA PRESCOTT HOUSE

Active
Other names
SequelCare of Arizona, LLC dba Prescott House
Organization subpart
No

Provider details

NPI number
Authorized official
MS. BROOKE WILSON (SENIOR CREDENTIALING SPECIALIST)
(928) 910-7644
Entity
Organization

Contact information

Practice address
4001 NORTH CATHERINE DRIVE, PRESCOTT VALLEY, AZ 86314
(928) 775-7118
Mailing address
2517 N GREAT WESTERN DR., SUITE P, PRESCOTT VALLEY, AZ 86314-2597
(928) 777-3280
(928) 227-8493

Taxonomy

Speciality
Code
Description
License number
State
320800000X
Mental Illness Community Based Residential Treatment Facility
Primary
BH-3650
AZ

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
560284
AHCCCS ID
AZ
05
560284
AZ
01
BH-3650
LIC #
AZ
01
BH3650
LIC#
AZ
01
BH4980
LIC #
AZ
Enumeration date
10/02/2006
Last updated
07/06/2022
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