Arrowhead Lodge

Primary specialty

Substance Abuse Rehabilitation FacilityTaxonomy code 324500000X

License

BH-3965 Issued in AZ

Legal business name

ARROWHEAD LODGE

Practice address

5113 W Arrowhead Dr
Prescott, AZ 86305-7304

Phone

(626) 797-9977

NPI assigned

Jun 29, 2012

Organization subpart

Yes

Parent organization

THE MONTANA SOCIETYAs reported in NPPES

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Kenneth Anthony Gray, LCSW

Title

Insurance Coordinator

Phone

(626) 797-9977

Specialties & licenses 1

Addresses

Part of

Arrowhead Lodge

Parent organization (reported in NPPES) 1

This organization reports itself as a subpart in NPPES; the parent’s legal name matches this organization in the same state.

• Montana Society Incorporated

  • Substance Abuse Rehabilitation Facility
  • Prescott, AZ
  • NPI 1023385390
  NPPES parent name

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1340928000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1340928000000",
    "number": "1043574577",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5113 W ARROWHEAD DR",
            "city": "PRESCOTT",
            "state": "AZ",
            "postal_code": "863057304"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5113 W ARROWHEAD DR",
            "city": "PRESCOTT",
            "state": "AZ",
            "postal_code": "863057304",
            "telephone_number": "626-797-9977"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ARROWHEAD LODGE",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "THE MONTANA SOCIETY",
        "enumeration_date": "2012-06-29",
        "last_updated": "2012-06-29",
        "status": "A",
        "authorized_official_last_name": "GRAY",
        "authorized_official_first_name": "KENNETH",
        "authorized_official_middle_name": "ANTHONY",
        "authorized_official_title_or_position": "INSURANCE COORDINATOR",
        "authorized_official_telephone_number": "626-797-9977",
        "authorized_official_credential": "LCSW"
    },
    "taxonomies": [
        {
            "code": "324500000X",
            "taxonomy_group": "",
            "desc": "Substance Abuse Rehabilitation Facility",
            "state": "AZ",
            "license": "BH-3965",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Natalie Devin Arnold, SLP-CFY
• Tracy Lynn Arnold, RDH
• James Arocho, MD
• Osmund Gregory Arriola, PHARM. D.
• Arrow Housecall
• Arrowhead Lodge, LLC
• Michael Anthony Arroyo, MD
• James Brayshaw Arthur, M.D.
• Ascend Autism Spectrum Center for Educational and Neurological Develop
• Julia Ascoly, M.S. ED., CCC-SLP

• Substance Abuse Rehabilitation Facility in Prescott, AZ
• Providers in Prescott, AZ by specialty
• Substance Abuse Rehabilitation Facility in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 29, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.