PRONGHORN PSYCHIATRY NPI 1700377983

NPI Information

PRONGHORN PSYCHIATRY is an adult mental health clinic center in Prescott Valley, AZ. The provider is an entity, facility, or distinct part of a facility providing diagnostic, treatment, and prescriptive services related to mental and behavioral disorders in adults. PRONGHORN PSYCHIATRY NPI is 1700377983. The provider is registered as an organization entity type.
The provider Is Doing Business As Stoneridge Centers For Brain And Addiction Treatment.

The provider's business location address is:

5940 E. COPPER HILL DR
SUITE E
PRESCOTT VALLEY, AZ
ZIP 86314
Phone: (928) 583-7799
Fax: (928) 583-7891

The provider's authorized official is Barbara Thompson .
The authorized official title is Chief Information Officer and has the following contact phone number (928) 583-7799.

The CLIA number assigned to this NPI record is 03D2131600 - other with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 5/23/2018 and was last updated on 5/23/2018.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

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