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KELLY MEGAHAN
>> Community Based Residential Treatment Facility, Mental Illness >> Residential Treatment FacilitiesRegistrant NPI Number: 1346660602
Individual Registrant: KELLY MEGAHAN
Gender: F
Sole Proprietor
Gender: F
Sole Proprietor
Location and contact information for practice:
3011 S SYCAMORE CANYON DRIVE PARKS, AZ 86018-0304 US
Tel: 928-853-4152 Fax: --
Tel: 928-853-4152 Fax: --
Contact information for business:
PO BOX 50304 PARKS, AZ 86018-0304 US
Tel: 928-853-4152 Fax: --
Tel: 928-853-4152 Fax: --
Registration Information:
NPI: 1346660602
Entity Type: Individual
Entity Type: Individual
Specialty information:
| Primary | Code | Category/Description | State | License Number |
|---|---|---|---|---|
| Y | 320800000X | Residential Treatment Facilities Community Based Residential Treatment Facility, Mental Illness | AZ | 3092313 |
Legacy codes, insurance codes and state license numbers:
| Issuer | Number | State | Type |
|---|---|---|---|
