Country Health Care

NPI #1356147128 in Phoenix, Arizona

Provider Information

NPI Number: 1356147128
Entity Type: Organization
Organization Name: Country Health Care
Primary Specialty: Substance Abuse Rehabilitation Facility - Substance Abuse Treatment, Children
Enumeration Date: Feb 21, 2025
Last Updated: Feb 21, 2025

Practice Location

Address: 4444 N 25TH ST UNIT 43
City: Phoenix
State: Arizona
ZIP Code: 85016-5645
Phone: (602) 363-2743

Authorized Official

Name: MR. KENNETH SEAN COUNTRYMAN, JD
Title: PRESIDENT
Phone: (602) 363-2743

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Social Worker - Clinical — Clinical	1041C0700X
Substance Abuse Rehabilitation Facility - Substance Abuse Treatment, Children — Substance Abuse Treatment, Children	3245S0500X	Primary

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