Organization
LAKE MONTEZUMA RTC, LLC
Active
Other names
Sedona Sky Academy
Organization subpart
No
Provider details
NPI number
Authorized official
TAMMY BEHRMANN (EXECUTIVE DIRECTOR)
(928) 567-1322
Entity
Organization
Contact information
Practice address
3090 CORONADO TRAIL, RIMROCK, AZ 86335-5283
(928) 567-1322
(928) 567-1323
Mailing address
3090 CORONADO TRAIL, RIMROCK, AZ 86335-5283
(928) 567-1322
(928) 567-1323
Taxonomy
Speciality
Code
Description
License number
State
322D00000X
Emotionally Disturbed Childrens' Residential Treatment Facility
Primary
BH4470
AZ
Other
Enumeration date
04/23/2014
Last updated
04/23/2014
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