Organization · Type 2 NPI
Re-Creation Retreat LLC
Mental Illness Community Based Residential Treatment Facility · Fredonia, AZ
NPI number
1629339437
Active
Practice location
455 South Main
Fredonia, AZ 86022
Mailing address
380 W Los Barancos Ln, P.o. Box 61
Kanab, UT 84741-3311
Specialties and licenses
| Taxonomy | Code | License |
|---|---|---|
| Mental Illness Community Based Residential Treatment Facility Primary | 320800000X | BH-3895 (AZ) |
| Substance Abuse Rehabilitation Facility | 324500000X | BH-3895 (AZ) |
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.
About NPI 1629339437
Re-Creation Retreat LLC's National Provider Identifier is 1629339437, issued on Jun 7, 2012. The primary taxonomy on file is Mental Illness Community Based Residential Treatment Facility (320800000X), and the practice location is in Fredonia, AZ. The record was last updated on Nov 21, 2012.