PRESCOTT ADDICTION RECOVERY CENTER LLC (NPI# 1013460385) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1013460385 |
| Entity Type | Organization |
| Organization Name | PRESCOTT ADDICTION RECOVERY CENTER LLC |
| Other Organization Name | PARC |
| Practice Address |
1630 Shoup St Suite B Prescott AZ 86305-1343 |
| Practice Telephone | 9282272448 |
| Mailing Telephone | 9282272448 |
| Enumeration Date | 2016-08-03 |
| Last Update Date | 2016-08-03 |
| Authorized Official Name | KENNETH CHANCE (VICE PRESIDENT) |
| Authorized Official Telephone | 9282272448 |
| Authorized Official Credential | D. DIV. |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 251S00000X | Community/Behavioral Health | OTC7711 | AZ | Agencies |
| Other Name | Type Code |
|---|---|
| PARC | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1790129401 | Prescott Addiction Recovery Center LLC | Community/Behavioral Health | 1630 Shoup St, Ste B, Prescott, AZ 86305-1343 | 2013-04-24 |
| Street Address |
1630 SHOUP ST SUITE B |
| City | PRESCOTT |
| State | AZ |
| Zip Code | 86305-1343 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1023385390 | Montana Society Incorporated | Substance Abuse Rehabilitation Facility | 1630 Shoup St, Prescott, AZ 86305-1343 | 2011-11-30 |
| 1285114413 | Jason Klarer | Counselor | 1630 Shoup St, Prescott, AZ 86305-1343 | 2018-08-16 |
| 1548669039 | Robert Potter | Counselor | 1630 Shoup St, Prescott, AZ 86305-1343 | 2014-08-20 |
| 1790129401 | Prescott Addiction Recovery Center LLC | Community/Behavioral Health | 1630 Shoup St, Ste B, Prescott, AZ 86305-1343 | 2013-04-24 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1972005395 | Granite View Adult Care Home LLC | Assisted Living Facility | 7105 Williamson Valley Road, Prescott, AZ 86305 | 2018-03-01 |
| 1215468095 | Valerie Williams | Occupational Therapist | 926 S. Hinman Dr., Prescott, AZ 86305 | 2017-03-23 |
| 1174073837 | Caspian Gleam Medical Center LLC | Clinic/Center | 3130 Stillwater Drive, Suite B, Prescott, AZ 86305 | 2016-10-06 |
| 1114388634 | Marla Beth Perkins | Speech-Language Pathologist | 3160 Stillwater Dr., Prescott, AZ 86305 | 2016-03-10 |
| 1790159853 | Michele A. Bibeau, D.d.s. | Dentist | 1058 Fair Street, Suite A, Prescott, AZ 86305 | 2015-11-30 |
| 1609264837 | Integrative Pain Centres of Prescott | Pain Medicine | 3769 Crossings Drive, Suite B, Integrative Pain Centres of Prescott, Prescott, AZ 86305 | 2014-12-22 |
| 1649697251 | Sharon Marilyn Jackson | Counselor | 3636 Crossings Drive, Prescott, AZ 86305 | 2014-03-20 |
| 1215351259 | Stefanie Maneval | Registered Nurse | 900 Iron Springs Rd, Prescott, AZ 86305 | 2014-02-11 |
| 1508207523 | Recovery In The Pines, LLC | Community/Behavioral Health | 919 12th Place #13, Prescott, AZ 86305 | 2013-07-08 |
| 1871857359 | Neal Herbert Segovia Cabaluna | Internal Medicine | 3773 Crossings Dr Ste C, Prescott, AZ 86305 | 2012-06-28 |
| Find all providers in zip 86305 | ||||
| Taxonomy Code | 251S00000X |
| Grouping | Agencies |
| Classification | Community/Behavioral Health |
| A private or public agency usually under local government jurisdiction, responsible for assuring the delivery of community based mental health, mental retardation, substance abuse and/or behavioral health services to individuals with those disabilities. Services may range from companion care, respite, transportation, community integration, crisis intervention and stabilization, supported employment, day support, prevocational services, residential support, therapeutic and supportive consultation, environmental modifications, intensive in-home therapy and day treatment, in addition to traditional mental health and behavioral treatment. |
| Notes: Source: National Medicaid EDI HIPAA NPI Sub Work Group [1/1/2007: modified definition] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1861023905 | Blueprints Therapeutic Services LLC | Community/Behavioral Health | 1065 Northside Dr, Prescott, AZ 86301-1415 | 2020-01-28 |
| 1003372491 | Seaglass Recovery | Community/Behavioral Health | 711 W Gurley St, Prescott, AZ 86305-3621 | 2019-02-11 |
| 1407398621 | Chapter 5 Counseling Center LLC. | Community/Behavioral Health | 973 W Gurley St, Prescott, AZ 86305-2817 | 2016-11-07 |
| 1447640826 | Chapter 5 | Community/Behavioral Health | 726 W Gurley St, Prescott, AZ 86305-3629 | 2015-01-23 |
| 1235529629 | Chapter 5 Counseling Center, LLC | Community/Behavioral Health | 822 W Gurley St, Prescott, AZ 86305-3624 | 2015-01-23 |
| 1508207523 | Recovery In The Pines, LLC | Community/Behavioral Health | 919 12th Place #13, Prescott, AZ 86305 | 2013-07-08 |
| 1528304367 | Catholic Charities Community Services | Community/Behavioral Health | 434 W Gurley St, Prescott, AZ 86301-3616 | 2012-12-26 |
| 1952646002 | Laura Crimmins Pllc | Community/Behavioral Health | 711 Whipple St, Prescott, AZ 86301-1717 | 2012-11-30 |
| 1932453073 | Oasis Addiction Counseling LLC | Community/Behavioral Health | 445 Miller Valley Rd, Prescott, AZ 86301-2925 | 2012-10-26 |
| 1225391402 | Cornerstone Recovery Center | Community/Behavioral Health | 655 W Gurley St, Prescott, AZ 86305-3619 | 2012-06-21 |
| 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.