NORTHERN ARIZONA CENTER FOR ADDICTION, LLC


Address: 195 Plaza Dr, Prescott, AZ 86303-5549
Phone: 9284995687

NORTHERN ARIZONA CENTER FOR ADDICTION, LLC (NPI# 1770955338) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).

Provider Overview

Nation Provider ID (NPI) 1770955338
Entity Type Organization
Organization Name NORTHERN ARIZONA CENTER FOR ADDICTION, LLC
Practice Address 195 Plaza Dr
Prescott
AZ 86303-5549
Practice Telephone 9284995687
Practice Fax Number 9287781089
Mailing Telephone 9284995687
Mailing Fax Number 9287781089
Enumeration Date 2015-10-22
Last Update Date 2020-02-11
Authorized Official Name BRYAN MATTHEW DISIMONE (ACCOUNT MANAGER)
Authorized Official Telephone 9282771498
Is Organization Subpart N

Taxonomy

Primary Taxonomy Code Classification License Number License State Taxonomy Group
Y 261QR0405X Clinic/Center
Specialization: Rehabilitation, Substance Use Disorder
OTC 7348 AZ Ambulatory Health Care Facilities

Provider Secondary Practice Location

Address Telephone Number Fax Number
545 S Lakeview Dr, Prescott, AZ 863017655 9282771498

Office Location

Street Address 195 PLAZA DR
City PRESCOTT
State AZ
Zip Code 86303-5549

Providers in the same zip code

NPI Name Taxonomy Address Enumeration
1518447598 Jacqueline Schlosser Respite Care 237 S. Washington Ave., Prescott, AZ 86303 2018-08-18
1033699210 Anna Rachel Seno Psychologist 300 S Granite Street, Prescott, AZ 86303 2018-08-17
1871944322 Jessie Deverna Counselor 450 W Goodwin St Suite 103b, Prescott, AZ 86303 2016-06-27
1154782845 Walmart Pharmacy 1120 N. Opal Dr., Prescott, AZ 86303 2016-03-09
1710377650 Compass Recovery Center LLC Clinic/Center 711 S. Granite St, Prescott, AZ 86303 2015-01-30
1154727527 Anne Gurley Klever Pharmacist 500 Arizona 89, Prescott, AZ 86303 2014-11-13
1295131860 Kathi Sabot Registered Nurse 146 S. Granite Street, Prescott Unified School District, Prescott, AZ 86303 2014-11-10
1457697989 Kim K. Mcintyre Counselor 505 S. Cortez St., Prescott, AZ 86303 2013-01-03
1578885257 Wesley Carl Kitchens Counselor 315 W Goodwin St, Prescott, AZ 86303 2010-02-22
1588805907 Jacob Lee Bean Physical Therapist 6820 El Dorado Dr, Prescott, AZ 86303 2009-03-14
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Taxonomy Information

Taxonomy Code 261QR0405X
Grouping Ambulatory Health Care Facilities
Classification Clinic/Center
Specialization Rehabilitation, Substance Use Disorder

Taxonomy Definition

Definition to come...

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NPI Name Taxonomy Address Enumeration
1609429315 Blueprints Therapeutic Services LLC Clinic/Center 114 S Virginia St, Prescott, AZ 86303-3803 2019-07-22
1114309945 Practical Development Clinic/Center 1965 Commerce Center Cir, Suite C, Prescott, AZ 86301-4484 2015-06-29
1871987495 Embark Recovery LLC Clinic/Center 3727 Karicio Ln, Prescott, AZ 86303-6829 2015-03-20
1710377650 Compass Recovery Center LLC Clinic/Center 711 S. Granite St, Prescott, AZ 86303 2015-01-30
1528401072 Freedom Recovery Center, LLC. Clinic/Center 1470 W Gurley St, Prescott, AZ 86305-2855 2013-04-15
1487701454 Decision Point, LLC Clinic/Center 505 W. Whipple St., Prescott, AZ 86301-1747 2007-01-04
1306475751 Pinnacle Treatment Center LLC Clinic/Center 445 Miller Valley Rd, Prescott, AZ 86301-2925 2020-04-07
1184193963 Embark Recovery LLC Clinic/Center 3727 Karicio Ln, Prescott, AZ 86303-6829 2018-11-21
1952807414 Holdfast Recovery Clinic/Center 1470 W Gurley St, Prescott, AZ 86305-2855 2018-04-03
1295110476 Royal Life Centers, LLC Clinic/Center 655 W Gurley St, Prescott, AZ 86305-3619 2015-07-29
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Competitor

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City PRESCOTT
Zip Code 86303

Improve Information

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Dataset Information

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.

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