Provider Demographics
NPI:1255059705
Name:COMPLETE JOY BEHAVIORAL HEALTH LLC
Entity type:Organization
Organization Name:COMPLETE JOY BEHAVIORAL HEALTH LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:COO
Authorized Official - Prefix:
Authorized Official - First Name:DICKSON
Authorized Official - Middle Name:
Authorized Official - Last Name:ATTAH
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:623-200-6017
Mailing Address - Street 1:1711 N STOCKTON HILL RD
Mailing Address - Street 2:
Mailing Address - City:KINGMAN
Mailing Address - State:AZ
Mailing Address - Zip Code:86401-4673
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:3448 N YAVAPAI ST
Practice Address - Street 2:
Practice Address - City:KINGMAN
Practice Address - State:AZ
Practice Address - Zip Code:86401-3710
Practice Address - Country:US
Practice Address - Phone:623-200-6017
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-08-19
Last Update Date:2022-08-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes323P00000XResidential Treatment FacilitiesPsychiatric Residential Treatment Facility