REBOOT DETOX AZ LLC


Address: 1132 S Oakland, Mesa, AZ 85206-2682
Phone: 7329031964

REBOOT DETOX AZ LLC (NPI# 1417458753) 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) 1417458753
Entity Type Organization
Organization Name REBOOT DETOX AZ LLC
Other Organization Name FOOTPRINTS TO RECOVERY
Practice Address 1132 S Oakland
Mesa
AZ 85206-2682
Mailing Address Po Box 1030
Brick
NJ 08723-0090
Practice Telephone 7329031964
Mailing Telephone 7329031964
Enumeration Date 2018-02-22
Last Update Date 2018-02-22
Authorized Official Name YESHAYA MARKOVITS (CFO)
Authorized Official Telephone 7188681600
Is Organization Subpart N

Taxonomy

Primary Taxonomy Code Classification License Number License State Taxonomy Group
Y 324500000X Substance Abuse Rehabilitation Facility IFBH8704 AZ Residential Treatment Facilities

Other Provider/Organization Names

Other Name Type Code
FOOTPRINTS TO RECOVERY Doing Business As Name - Organization

Office Location

Street Address 1132 S OAKLAND
City MESA
State AZ
Zip Code 85206-2682

Providers in the same zip code

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1720693062 Inner Balance Counseling LLC Counselor 4111 E Auto Valley Drive, Suite 101, Mesa, AZ 85206 2020-09-14
1356978969 Choices 4 Change Counseling and Coaching LLC Social Worker 3707 E Southern Ave., Suite 2027, Mesa, AZ 85206 2020-03-24
1023651288 Jason Mcclure Hearing Instrument Specialist 5540 E Broadway Rd., Mesa, AZ 85206 2019-10-21
1255995361 Vhs of Phoenix Inc General Acute Care Hospital 5750 E. Baseline Rd., Mesa, AZ 85206 2019-04-24
1932682184 Adam Fishel Frose Psychologist 4555 E Inverness Ave Ste 112, Mesa, AZ 85206 2018-09-13
1376024737 Robyn Kathleen Hall Psychologist 4115 East Valley Auto Drive, Suite 208, Mesa, AZ 85206 2018-08-23
1790264984 Perspective Health, LLC Clinic/Center 1959 S. Power Rd, Suite 103, #206, Mesa, AZ 85206 2018-08-09
1033605159 Rebecca Ann Maro Nurse Practitioner 6750 E Baywood Ave Ste 502, Mesa, AZ 85206 2018-07-02
1982195624 Spark Performance and Physiotherapy Clinic/Center 6056 East Basline Road, Suite 147, Mesa, AZ 85206 2018-05-29
1336645993 Ashley Wright Audiologist-Hearing Aid Fitter 1423 S Higley Rd Ste 119, Mesa, AZ 85206 2018-04-03
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Taxonomy Information

Taxonomy Code 324500000X
Grouping Residential Treatment Facilities
Classification Substance Abuse Rehabilitation Facility

Taxonomy Definition

A facility or distinct part of a facility that provides a 24 hr therapeutically planned living and rehabilitative intervention environment for the treatment of individuals with disorders in the abuse of drugs, alcohol, and other substances.
Notes: [7/1/2003: modified title, modified definition]

Providers in the same taxonomy and city

NPI Name Taxonomy Address Enumeration
1073179883 Dara II Inc Substance Abuse Rehabilitation Facility 4645 E Ellis Cir, Mesa, AZ 85205-5238 2019-05-16
1326491283 Soba Mesa LLC Substance Abuse Rehabilitation Facility 6215 E Arbor Ave, Mesa, AZ 85206-6064 2016-07-15
1841649258 Big Sky Recovery LLC Substance Abuse Rehabilitation Facility 2360 N Robin Ln, Mesa, AZ 85213-2474 2016-06-07
1104209352 Recovery Homes, Inc Substance Abuse Rehabilitation Facility 141 South Center Street, Suite B, Mesa, AZ 85210 2015-07-07
1710369483 Recovery Homes, Inc Substance Abuse Rehabilitation Facility 143 S Center St, Suite A, Mesa, AZ 85210-1307 2015-06-18
1306243084 Residents At The Heights LLC Substance Abuse Rehabilitation Facility 215 S Power Rd Ste 1251, Mesa, AZ 85206-5238 2014-11-25
1538599469 The River Source Iop LLC Substance Abuse Rehabilitation Facility 128 W Pepper Pl, Mesa, AZ 85201-7317 2013-11-13
1578807145 Recovery Help, LLC. Substance Abuse Rehabilitation Facility 3945 E Broadway Rd, Mesa, AZ 85206-1030 2012-11-20
1497833644 Anasazi Foundation Substance Abuse Rehabilitation Facility 1424 S Stapley Dr, Mesa, AZ 85204-5877 2006-11-02
1316505753 Light House Group Home LLC Substance Abuse Rehabilitation Facility 108 E 2nd Ave, Mesa, AZ 85210-1410 2019-05-31
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Competitor

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City MESA
Zip Code 85206

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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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