Organization · Type 2 NPI

Alta Vista Group Home

Emotionally Disturbed Childrens' Residential Treatment Facility · Hereford, AZ

NPI number 1215038757 Active

Practice location

4108 E Ramsey Rd
Hereford, AZ 85615-8917

Fax (520) 378-6553

Specialties and licenses

TaxonomyCodeLicense
Emotionally Disturbed Childrens' Residential Treatment Facility Primary 322D00000XBH2414 (AZ)

Emotionally Disturbed Childrens' Residential Treatment Facility: A residential facility that provides habilitation services and other care and treatment to children diagnosed with mental health illness, behavioral issues, and intellectual disabilities and are not able to live independently.

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About NPI 1215038757

Alta Vista Group Home's National Provider Identifier is 1215038757, issued on Sep 26, 2006. The primary taxonomy on file is Emotionally Disturbed Childrens' Residential Treatment Facility (322D00000X), and the practice location is in Hereford, AZ. The record was last updated on Aug 22, 2020.