THE WICK HOME FOR EMOTIONAL GROWTH AND RECOVERY (NPI# 1972783355) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1972783355 |
| Entity Type | Organization |
| Organization Name | THE WICK HOME FOR EMOTIONAL GROWTH AND RECOVERY |
| Practice Address |
2102 E Fir St Cottonwood AZ 86326 |
| Practice Telephone | 9286399425 |
| Practice Fax Number | 9286391484 |
| Mailing Telephone | 9286399425 |
| Mailing Fax Number | 9286391484 |
| Enumeration Date | 2007-11-14 |
| Last Update Date | 2007-11-14 |
| Authorized Official Name | MR. TODD ROSENBLATT (PROGRAM DIRECTOR) |
| Authorized Official Telephone | 9286399425 |
| Authorized Official Credential | M.ED |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 322D00000X | Residential Treatment Facility, Emotionally Disturbed Children | Residential Treatment Facilities |
| Street Address |
2102 E FIR ST |
| City | COTTONWOOD |
| State | AZ |
| Zip Code | 86326 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1679954895 | Isabelle Maisse Griffith | Pharmacist | 1100 E Highway 89a, Cottonwood, AZ 86326 | 2015-06-12 |
| 1184982266 | Northern Arizona Healthcare Provider Group, LLC | Family Medicine | 450 South Willard Street, Cottonwood, AZ 86326 | 2012-04-26 |
| 1922391663 | Ronald D. Carsrud | Hearing Instrument Specialist | 657 E Cottonwood St., Ste 6c, Cottonwood, AZ 86326 | 2011-05-26 |
| 1760712749 | Chuck Thomas Calvano | Pharmacist | 550 S Main, Cottonwood, AZ 86326 | 2010-01-13 |
| 1528231438 | Elizabeth Lightner Mccarrell | Emergency Medicine | 269 S Candy Lane, Cottonwood, AZ 86326 | 2008-04-11 |
| 1750560165 | David T Sayle | Nurse Practitioner | 800 Cove Parkway, Cottonwood, AZ 86326 | 2007-11-01 |
| 1003001033 | Country Care Inc | Assisted Living Facility | 3980 E Cassie Lane, Cottonwood, AZ 86326 | 2007-09-12 |
| 1154527778 | Laurel A Mueller | Family Medicine | 51 Brian Mickelsen Pkwy, Community Health Center of Yavapai, Cottonwood, AZ 86326 | 2007-06-21 |
| 1841401700 | Bruce Alan Moseng | Chiropractor | 240 Jennifer Lane, Ste 103, Cottonwood, AZ 86326 | 2007-05-24 |
| 1932311081 | Mathis Eye Care LLC | Optometrist | 2003 E. Rodeo Dr., Cottonwood, AZ 86326 | 2007-05-03 |
| Find all providers in zip 86326 | ||||
| Taxonomy Code | 322D00000X |
| Grouping | Residential Treatment Facilities |
| Classification | Residential Treatment Facility, Emotionally Disturbed Children |
| A provider facility or distinct part of the organization which renders an interdisciplinary program of mental health treatment to individuals under 21 years of age who have persistent dysfunction in major life areas. The dysfunction is of an extent and pervasiveness that requires a protected and highly structured therapeutic environment. These organizations, or distinct part of organizations, exclude those that provide acute psychiatric care, partial hospitalization, group living, therapeutic schooling, primary diagnosis substance abuse disorder treatment, or primary diagnosis mental retardation or developmental disability treatment. |
| Notes: Source: U.S. Department of Defense Regulation 6010.8-R, Chapter 6. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1528666039 | Rehoboth LLC | Residential Treatment Facility, Emotionally Disturbed Children | 46136 W Mountain View Rd # A, Maricopa, AZ 85139-6796 | 2020-10-16 |
| 1962022665 | New Hope of Arizona, Inc. | Residential Treatment Facility, Emotionally Disturbed Children | 8710 W Watkins St, Tolleson, AZ 85353-9028 | 2020-04-22 |
| 1639798143 | Anthony Udoinwang | Residential Treatment Facility, Emotionally Disturbed Children | 10435 W Reade Ave, Glendale, AZ 85307-4237 | 2020-04-14 |
| 1033756358 | Native Music Coalition | Residential Treatment Facility, Emotionally Disturbed Children | 5150 S Crazy Cat Ln, Tucson, AZ 85735 | 2019-12-05 |
| 1013558311 | Back To Life Incorporated | Residential Treatment Facility, Emotionally Disturbed Children | 6420 W Cocopah St, Phoenix, AZ 85043 | 2019-10-08 |
| 1487118865 | Serenity Preferred LLC | Residential Treatment Facility, Emotionally Disturbed Children | 17829 W Columbine Dr, Surprise, AZ 85388-5628 | 2019-01-30 |
| 1407333958 | Copa's Caring Hands LLC. | Residential Treatment Facility, Emotionally Disturbed Children | 42251 W Bravo Dr, Maricopa, AZ 85138-2295 | 2018-07-26 |
| 1538668983 | Starks Homes LLC | Residential Treatment Facility, Emotionally Disturbed Children | 7325 E Fayette St, Tucson, AZ 85730-2324 | 2018-02-12 |
| 1881100147 | Anna Marie Barrios | Residential Treatment Facility, Emotionally Disturbed Children | 18811 N 7th Dr, Phoenix, AZ 85027-5508 | 2017-12-22 |
| 1033625926 | Youth Transition Services, Inc. | Residential Treatment Facility, Emotionally Disturbed Children | 1190 S Boulder St Unit D, Gilbert, AZ 85296-3792 | 2017-12-14 |
| Find all providers with the same taxonomy | ||||
| City | COTTONWOOD |
| Zip Code | 86326 |
Please comment or provide details below to improve the information on THE WICK HOME FOR EMOTIONAL GROWTH AND RECOVERY.
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.