Organization
PRESCOTT ADDICTION RECOVERY CENTER LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. KENNETH CHANCE D.D. (CEO/PRESIDENT)
(928) 227-2448
Entity
Organization
Contact information
Practice address
1630 SHOUP ST, STE B, PRESCOTT, AZ 86305-1343
(928) 227-2448
(928) 441-1516
Mailing address
1630 SHOUP ST, STE B, PRESCOTT, AZ 86305-1343
(928) 227-2448
(928) 441-1516
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
Primary
—
—
Other
Enumeration date
04/24/2013
Last updated
07/07/2016
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