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).
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 |
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 |
Address | Telephone Number | Fax Number |
---|---|---|
545 S Lakeview Dr, Prescott, AZ 863017655 | 9282771498 |
Street Address |
195 PLAZA DR |
City | PRESCOTT |
State | AZ |
Zip Code | 86303-5549 |
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 |
Find all providers in zip 86303 |
Taxonomy Code | 261QR0405X |
Grouping | Ambulatory Health Care Facilities |
Classification | Clinic/Center |
Specialization | Rehabilitation, Substance Use Disorder |
Definition to come... |
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 |
Find all providers in PRESCOTT |
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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.