Alta Vista Group Home

NPI #1215038757 in Hereford, Arizona

Provider Information

NPI Number
1215038757
Entity Type
Organization
Organization Name
Alta Vista Group Home
Primary Specialty
Residential Treatment Facility, Emotionally Disturbed Children
Enumeration Date
Sep 26, 2006
Last Updated
Aug 22, 2020

Practice Location

Address
4108 E RAMSEY RD
State
Arizona
ZIP Code
85615-8917
Phone
(520) 378-6466

Authorized Official

Name
MR. BROOKE E BALCH
Title
CFO
Phone
(256) 880-3339

Specialties & Taxonomy Codes

Specialty
Residential Treatment Facility, Emotionally Disturbed Children

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