The Wick Home for Emotional Growth and Recovery

Primary specialty

Emotionally Disturbed Childrens' Residential Treatment FacilityTaxonomy code 322D00000X

Legal business name

THE WICK HOME FOR EMOTIONAL GROWTH AND RECOVERY

Practice address

2102 E Fir St
Cottonwood, AZ 86326

Phone

(928) 639-9425

Fax

(928) 639-1484

NPI assigned

Nov 14, 2007

Last updated

Nov 14, 2007By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Mr. Todd Rosenblatt, M.ED

Title

Program Director

Phone

(928) 639-9425

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1194998400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1194998400000",
    "number": "1972783355",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2102 E FIR ST",
            "city": "COTTONWOOD",
            "state": "AZ",
            "postal_code": "86326",
            "telephone_number": "928-639-9425",
            "fax_number": "928-639-1484"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2102 E FIR ST",
            "city": "COTTONWOOD",
            "state": "AZ",
            "postal_code": "86326",
            "telephone_number": "928-639-9425",
            "fax_number": "928-639-1484"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "THE WICK HOME FOR EMOTIONAL GROWTH AND RECOVERY",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-11-14",
        "last_updated": "2007-11-14",
        "status": "A",
        "authorized_official_last_name": "ROSENBLATT",
        "authorized_official_first_name": "TODD",
        "authorized_official_title_or_position": "PROGRAM DIRECTOR",
        "authorized_official_telephone_number": "928-639-9425",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "M.ED"
    },
    "taxonomies": [
        {
            "code": "322D00000X",
            "taxonomy_group": "",
            "desc": "Residential Treatment Facility, Emotionally Disturbed Children",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Sarah Ann Torabi, CRNA

• Emotionally Disturbed Childrens' Residential Treatment Facility in Cottonwood, AZ
• Providers in Cottonwood, AZ by specialty
• Emotionally Disturbed Childrens' Residential Treatment Facility in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 14, 2007; 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.