Organization · Type 2 NPI
Estrella Vista Ranch LLC
Emotionally Disturbed Childrens' Residential Treatment Facility · Dragoon, AZ
Practice location
4911 East Silk Wind Blvd
Dragoon, AZ 85609
Mailing address
PO Box 235
Dragoon, AZ 85609-0235
Specialties and licenses
| Taxonomy | Code | License |
|---|---|---|
| Emotionally Disturbed Childrens' Residential Treatment Facility Primary | 322D00000X | BH-3062 (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.
About NPI 1689834103
Estrella Vista Ranch LLC's National Provider Identifier is 1689834103, issued on Jun 10, 2008. The primary taxonomy on file is Emotionally Disturbed Childrens' Residential Treatment Facility (322D00000X), and the practice location is in Dragoon, AZ. The record was last updated on Jun 10, 2008.