Provider Demographics
NPI:1073903472
Name:CHAPTER 5 COUNSELING CENTER, LLC
Entity Type:Organization
Organization Name:CHAPTER 5 COUNSELING CENTER, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:ROBERT
Authorized Official - Middle Name:
Authorized Official - Last Name:MORSE
Authorized Official - Suffix:
Authorized Official - Credentials:BSC
Authorized Official - Phone:928-541-0692
Mailing Address - Street 1:726 W GURLEY ST
Mailing Address - Street 2:
Mailing Address - City:PRESCOTT
Mailing Address - State:AZ
Mailing Address - Zip Code:86305-3629
Mailing Address - Country:US
Mailing Address - Phone:928-541-0692
Mailing Address - Fax:928-237-9768
Practice Address - Street 1:707 W GURLEY ST
Practice Address - Street 2:
Practice Address - City:PRESCOTT
Practice Address - State:AZ
Practice Address - Zip Code:86305-3621
Practice Address - Country:US
Practice Address - Phone:928-541-0692
Practice Address - Fax:928-237-9768
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-01-23
Last Update Date:2015-01-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZBH4452324500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes324500000XResidential Treatment FacilitiesSubstance Abuse Rehabilitation Facility