NPI 1497167480

The River Source

Organisation Substance Abuse Rehabilitation Facility Casa Grande, AZ

Practice location

Address: 950 N Arizola Rd STE 3, Casa Grande, AZ 85122-6196
Phone: (520) 836-2205
Fax: (520) 836-1882

Authorised official

Name: Daryl Ferrell
Title: Executive Director
Phone: (520) 836-2205

Registered specialties

Substance Abuse Rehabilitation Facility Primary

Residential Treatment Facilities Taxonomy 324500000X Licence 13-1381 (AZ)

Other Substance Abuse Rehabilitation Facility providers in Arizona →

Registry record

NPI: 1497167480
Entity type: Organization
NPI issued: 24 May 2014
Record last updated: 24 May 2014

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.