Organization
GRANITE MOUNTAIN BEHAVIORAL HEALTH CARE OF AZ, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
NICK HERB (ACCOUNTANT)
(602) 565-2055
Entity
Organization
Contact information
Practice address
8183 E FLORENTINE RD, PRESCOTT VALLEY, AZ 86314-8481
(602) 565-2055
(602) 565-2055
Mailing address
2651 N INDUSTRIAL WAY STE B, PRESCOTT VALLEY, AZ 86314-3545
(602) 565-2055
(866) 758-1208
Taxonomy
Speciality
Code
Description
License number
State
324500000X
Substance Abuse Rehabilitation Facility
Primary
—
AZ
Other
Enumeration date
12/18/2017
Last updated
12/18/2017
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