Organization
PRESCOTT HOUSE INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. HENRY DAYTON TURBERVILLE (EXECUTIVE DIR.)
(928) 776-8251
Entity
Organization
Contact information
Practice address
214 N. AZ AVE, PRESCOTT, AZ 86301
(928) 776-8251
(928) 771-2024
Mailing address
214 N. AZ AVE, PRESCOTT, AZ 86301
(928) 776-8251
(928) 771-2024
Taxonomy
Speciality
Code
Description
License number
State
320800000X
Mental Illness Community Based Residential Treatment Facility
BH-264
AZ
320800000X
Mental Illness Community Based Residential Treatment Facility
OTC-6470
AZ
324500000X
Substance Abuse Rehabilitation Facility
BH-264
AZ
324500000X
Substance Abuse Rehabilitation Facility
Primary
BH-4262
AZ
Other
Enumeration date
11/08/2010
Last updated
08/01/2018
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