Organization
CHAPTER 5 RECOVERY
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. MATTHEW FRANCIS LUCHINI (ACCOUNTS MANAGER)
(928) 533-4220
Entity
Organization
Contact information
Practice address
709 W GURLEY ST, PRESCOTT, AZ 86305
(928) 708-9615
(928) 708-9620
Mailing address
709 W GURLEY ST, PRESCOTT, AZ 86305
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
Primary
BH-4015
AZ
Other
Enumeration date
03/29/2012
Last updated
03/29/2012
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