| Organization Name: | SUMMIT BEHAVIORAL HEALTH OF ARIZONA |
| NPI Number: | 1023471646 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | BENJAMIN T ISENBERG (CEO) |
| Mailing Address: | 637 W Hillside Ave Prescott |
| State: | AZ US |
| Postal Code: | 863011909 |
| Phone Number: | 9287107021 |
| Fax Number: | 9287089620 |
| NPI Enumeration Date: | 03/31/2016 |
| NPI Last Update Date: | 03/31/2016 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 261QR0405X |
| License Number: | |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | |
| Taxonomy Type: | Ambulatory Health Care Facilities |
| Taxonomy Classification: | Clinic/Center |
| Taxonomy Specialization: | Rehabilitation, Substance Use Disorder |
| Taxonomy Definition: | |