Rosewood Ranch
Clinic/Center, Mental Health (Including Community Mental Health Center) in Wickenburg, AZ. Organization (NPI-2).
NPI number1023239159
StatusActive
Last updated in NPPESApr 11, 2019
Details
- NPI
- 1023239159
- Entity type
- Organization (NPI-2)
- Legal business name
- Rosewood Ranch
- Organization subpart
- No
- Enumeration date
- May 2, 2007
- Last updated
- Apr 11, 2019
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 261QM0801X | Clinic/Center, Mental Health (Including Community Mental Health Center) | BH-2495 | AZ | Yes |
Practice location
521 W Wickenburg WayWickenburg, AZ 85390-5200
Phone 928-684-8981 · Fax 928-684-9562
Mailing address
2300 Windy Ridge Pkwy Se Ste 210Atlanta, GA 30339-5665
Phone 470-440-1647 · Fax 470-440-1647
Authorized official
Tyeast Reynolds
Director Of Rcm
6788130428
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