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Ms. Crystal Lynn Bushong
Mental Illness Community Based Residential Treatment Facility in Prescott, Arizona
NPI 1508049230

Crystal Lynn Bushong is a Mental Illness Community Based Residential Treatment Facility based in Prescott, AZ. Crystal Lynn Bushong practices in Prescott, AZ. The NPI Number for Crystal Lynn Bushong is 1508049230 and holds a License No. (Arizona).

The current practice location address for Crystal Lynn Bushong is 2105 Demerse Ave, Prescott, AZ and can be reached out via phone at 928-717-8834.

Location: 2105 Demerse Ave, Prescott, AZ, 86301-1013
Profile Details Legacy Identifiers Practice Address Mailing Address Primary Taxonomy
person
Provider Profile Details
NPI Number
1508049230
Provider Name
Crystal Lynn Bushong
Credential
Provider Entity Type
Individual
Gender
Female
Address
2105 Demerse Ave, Prescott, AZ, 86301-1013
Phone Number
928-717-8834
Fax Number
Provider Enumeration Date
12/17/2007
Last Update Date
03/09/2024
institution
Provider Business Practice Location Address Details
Address
2105 Demerse Ave
City
Prescott
State
Arizona
Zip
86301-1013
Phone Number
928-717-8834
Fax Number
person
Provider Business Mailing Address Details
Address
2105 Demerse Ave
City
Prescott
State
Arizona
Zip
86301-1013
Phone Number
928-717-8834
Fax Number
person
Provider's Taxonomy Details 1
Type
Residential Treatment Facilities
Classification
Community Based Residential Treatment Facility, Mental Illness
Speciality
-
Taxonomy
320800000X
License No.
()
Definition
A home-like residential facility providing psychiatric treatment and psycho/social rehabilitative services to individuals diagnosed with mental illness.
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