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Lake Montezuma Rtc, Llc
Emotionally Disturbed Childrens' Residential Treatment Facility in Rimrock, Arizona
NPI 1972923472

Lake Montezuma Rtc, Llc is a Emotionally Disturbed Childrens' Residential Treatment Facility based in Rimrock, AZ. Lake Montezuma Rtc, Llc practices in Rimrock, AZ. The NPI Number for Lake Montezuma Rtc, Llc is 1972923472 and holds a License No. BH4470 (Arizona).

The current practice location address for Lake Montezuma Rtc, Llc is 3090 Coronado Trail, Rimrock, AZ and can be reached out via phone at 928-567-1322 and via fax at 928-567-1323.

Location: 3090 Coronado Trail, Rimrock, AZ, 86335-5283
Profile Details Legacy Identifiers Practice Address Mailing Address Primary Taxonomy
institution
Provider Profile Details
NPI Number
1972923472
Provider Name
Lake Montezuma Rtc, Llc
Credential
Provider Entity Type
Organization
Address
3090 Coronado Trail, Rimrock, AZ, 86335-5283
Phone Number
928-567-1322
Fax Number
928-567-1323
Provider Enumeration Date
04/23/2014
Last Update Date
03/09/2024
institution
Provider Business Practice Location Address Details
Address
3090 Coronado Trail
City
Rimrock
State
Arizona
Zip
86335-5283
Phone Number
928-567-1322
Fax Number
928-567-1323
person
Provider Business Mailing Address Details
Address
3090 Coronado Trail
City
Rimrock
State
Arizona
Zip
86335-5283
Phone Number
928-567-1322
Fax Number
928-567-1323
person
Provider's Taxonomy Details 1
Type
Residential Treatment Facilities
Classification
Residential Treatment Facility, Emotionally Disturbed Children
Speciality
-
Taxonomy
322D00000X
License No.
BH4470 (Arizona)
Definition
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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