| Roundsville Drug And Alcohol Treatment Of Arizona | |
|
610 N Bagby Dr Prescott AZ 86301-2588 | |
| (928) 848-2941 | |
| Not Available |
| Full Name | Roundsville Drug And Alcohol Treatment Of Arizona |
|---|---|
| Speciality | Counselor - Addiction (substance Use Disorder) |
| Location | 610 N Bagby Dr, Prescott, Arizona |
| Authorized Official Name and Position | Michael Harrison Colclasure (OWNER) |
| Authorized Official Contact | 9284203214 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Roundsville Drug And Alcohol Treatment Of Arizona 110 Rocky Dells Cir Prescott AZ 86303-5681 Ph: (928) 420-3214 | Roundsville Drug And Alcohol Treatment Of Arizona 610 N Bagby Dr Prescott AZ 86301-2588 Ph: (928) 848-2941 |
| NPI Number | 1891300299 |
|---|---|
| Provider Enumeration Date | 09/11/2020 |
| Last Update Date | 09/11/2020 |
| Certification Date | 09/11/2020 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1891300299 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101YA0400X | Counselor - Addiction (substance Use Disorder) | (* (Not Available)) | Primary |
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