Organization
THE WICK HOME FOR EMOTIONAL GROWTH AND RECOVERY
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. TODD ROSENBLATT M.ED (PROGRAM DIRECTOR)
(928) 639-9425
Entity
Organization
Contact information
Practice address
2102 E FIR ST, COTTONWOOD, AZ 86326
(928) 639-9425
(928) 639-1484
Mailing address
2102 E FIR ST, COTTONWOOD, AZ 86326
(928) 639-9425
(928) 639-1484
Taxonomy
Speciality
Code
Description
License number
State
322D00000X
Emotionally Disturbed Childrens' Residential Treatment Facility
Primary
—
—
Other
Enumeration date
11/14/2007
Last updated
11/14/2007
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