| Organization Name: | CANYONLANDS COMMUNITY HEALTHCARE - BH |
| NPI Number: | 1558609222 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | ELIZABETH G LATHAM (CEO) |
| Mailing Address: | 467 Vista Avenue Page |
| State: | AZ US |
| Postal Code: | 86040 |
| Phone Number: | 9286459675 |
| Fax Number: | |
| NPI Enumeration Date: | 01/30/2013 |
| NPI Last Update Date: | 01/30/2013 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 101YM0800X |
| License Number: | BH-4088 |
| Healthcare Provider Taxonomy: (Secondary) | N |
| State: | AZ |
| Taxonomy Type: | Behavioral Health & Social Service Providers |
| Taxonomy Classification: | Counselor |
| Taxonomy Specialization: | Mental Health |
| Taxonomy Definition: | |