PRONGHORN PSYCHIATRY NPI 1922401496

NPI Information

PRONGHORN PSYCHIATRY is a psychiatric hospital in Prescott Valley, AZ. The provider is an organization including a physical plant and personnel that provides multidisciplinary diagnostic and treatment mental health services to patients requiring the safety, security, and shelter of the inpatient or partial hospitalization settings. PRONGHORN PSYCHIATRY NPI is 1922401496. The provider is registered as an organization entity type.

The provider's business location address is:

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

The provider's authorized official is Jonathan Lee Marshall .
The authorized official title is Ceo and has the following contact phone number (775) 335-9932.

The CLIA number assigned to this NPI record is 03D2131536 - other - inpatient acute psych hos with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 9/29/2014 and was last updated on 11/30/2015.

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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