Lake Montezuma Rtc, LLC

NPI #1972923472 in Rimrock, Arizona

Provider Information

NPI Number: 1972923472
Entity Type: Organization
Organization Name: Lake Montezuma Rtc, LLC
Primary Specialty: Residential Treatment Facility, Emotionally Disturbed Children
Enumeration Date: Apr 23, 2014
Last Updated: Apr 23, 2014

Practice Location

Address: 3090 CORONADO TRAIL
City: Rimrock
State: Arizona
ZIP Code: 86335-5283
Phone: (928) 567-1322

Authorized Official

Name: TAMMY BEHRMANN
Title: EXECUTIVE DIRECTOR
Phone: (928) 567-1322

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Residential Treatment Facility, Emotionally Disturbed Children	322D00000X	Primary

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