Individual provider · Type 1 NPI
Crystal Lynn Bushong
Mental Illness Community Based Residential Treatment Facility · Prescott, AZ
NPI number
1508049230
Active
Practice location
2105 Demerse Ave
Prescott, AZ 86301-1013
Specialties and licenses
| Taxonomy | Code | License |
|---|---|---|
| Mental Illness Community Based Residential Treatment Facility Primary | 320800000X | None listed |
Mental Illness Community Based Residential Treatment Facility: A home-like residential facility providing psychiatric treatment and psycho/social rehabilitative services to individuals diagnosed with mental illness.
2 other providers at this address
About NPI 1508049230
Crystal Lynn Bushong's National Provider Identifier is 1508049230, issued on Dec 17, 2007. The primary taxonomy on file is Mental Illness Community Based Residential Treatment Facility (320800000X), and the practice location is in Prescott, AZ. The record was last updated on Dec 17, 2007.