Copper Canyon Academy
Organization Active NPI Emotionally Disturbed Childrens' Residential Treatment Facility · Rimrock, AZ
NPI 1972849149 · NPPES record last updated Dec 17, 2012
Key facts
- NPI
- 1972849149
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Emotionally Disturbed Childrens' Residential Treatment Facility 322D00000X
- License
- LPC12646 (AZ)
- Legal business name
- COPPER CANYON ACADEMY
- Practice address
- 3090 Coronado Trail
Rimrock, AZ 86335 - Phone
- (928) 567-1322
- NPI assigned
- Dec 17, 2012
- Organization subpart
- No
Authorized official
- Name
- Michael Gurr
- Title
- Program Director
- Phone
- (928) 567-1322
Corporate family (same tax ID) 2
National Provider Directory
- Tax ID family
- Copper Canyon Academy
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Emotionally Disturbed Childrens' Residential Treatment Facility | 322D00000X | LPC12646 | AZ | Yes |
Addresses
Primary practice location
3090 Coronado Trail
Rimrock, AZ 86335
Mailing address
3095 Coronado Trail
Rimrock, AZ 86335
Other providers in Rimrock, AZ
- Arizona Security & Home Automation, Inc
- Beaver Creek Elementary School District 26
- Kathleen Jo Buri-Baca
- Victoria Bursell
- Copper Canyon Academy
- Rodney Kent Courtney
- Kelly C Donohue
- Emoticare Rimrock LLC.
- Tamara Cy Garden
- Mark Gonchar
All providers in Rimrock, AZ · Emotionally Disturbed Childrens' Residential Treatment Facility in Arizona
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Dec 17, 2012. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.