VOGUE RECOVERY CENTER OUTPATIENT (NPI# 1497227771) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1497227771 |
| Entity Type | Organization |
| Organization Name | VOGUE RECOVERY CENTER OUTPATIENT |
| Practice Address |
4122 N 17th St Bldg C Phoenix AZ 85016-5922 |
| Mailing Address |
16501 Sherman Way Ste 100 Van Nuys CA 91406-3757 |
| Practice Telephone | 8183048071 |
| Enumeration Date | 2018-12-26 |
| Last Update Date | 2020-03-31 |
| Authorized Official Name | CECILIA VALENZUELA (BILLING SPECIALIST) |
| Authorized Official Telephone | 8182808063 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 324500000X | Substance Abuse Rehabilitation Facility | Residential Treatment Facilities |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| AZ | DEPARTMENT OF HEALTH SERVICES | OTC9282 | 01 |
| Street Address |
4122 N 17TH ST BLDG C |
| City | PHOENIX |
| State | AZ |
| Zip Code | 85016-5922 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1851992705 | Heatheranne Baker-oldfield | Counselor | 2415 E Camelback Rd Ste 700, Phoenix, AZ 85016 | 2020-11-06 |
| 1780215681 | Sip Home Systems - Mesa LLC | Home Health | 24th At Camelback, 2375 E. Camelback Rd., Suite 600, Phoenix, AZ 85016 | 2020-01-29 |
| 1760945588 | Wei Wei | Student in an Organized Health Care Education/Training Program | Phoenix Children's Hospital 1919 E. Thomas Rd., Phoenix, AZ 85016 | 2019-04-09 |
| 1942765623 | Grace Hatfield | Dietitian, Registered | Phoenix Childrens Hospital 1919 E Thomas Rd, Phoenix, AZ 85016 | 2019-02-06 |
| 1861977027 | Dawn Yvette Lima | Occupational Therapy Assistant | 3128 E Cheery Ln, Phoenix, AZ 85016 | 2018-10-03 |
| 1720583685 | Kristin Pauline Hicklin | Registered Nurse | 2930 E Camelback Rd Ste 100, Phoenix, AZ 85016 | 2018-03-24 |
| 1588181622 | Taness Eyre Billington | Pharmacist | 1625 E. Camelback Rd., Phoenix, AZ 85016 | 2017-08-29 |
| 1093239048 | Emma Ross | Psychologist | 1919 E Thomas Rd Bldg 4th, Phoenix, AZ 85016 | 2017-08-01 |
| 1609396985 | Mohammed Waseemuddin | Student in an Organized Health Care Education/Training Program | Phoenix Children's Hospital, 1919 E Thomas Rd, Phoenix, AZ 85016 | 2017-06-27 |
| 1144777632 | Amanda Mazerall | Occupational Therapist | 4333 N 24th Street, Apartment 223, Phoenix, AZ 85016 | 2016-09-01 |
| Find all providers in zip 85016 | ||||
| Taxonomy Code | 324500000X |
| Grouping | Residential Treatment Facilities |
| Classification | Substance Abuse Rehabilitation Facility |
| 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] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1932726361 | Northstar Homecare LLC | Substance Abuse Rehabilitation Facility | 5239 S 33rd Dr, Phoenix, AZ 85041-7411 | 2020-07-01 |
| 1891312542 | Semper Fidelis Behavioral Health Care, LLC | Substance Abuse Rehabilitation Facility | 8020 N 17th Dr, Phoenix, AZ 85021-5217 | 2020-06-29 |
| 1558988246 | Cmj Recovery Az LLC | Substance Abuse Rehabilitation Facility | 4122 N 17th St Bldg A, Phoenix, AZ 85016-5922 | 2020-06-29 |
| 1720549009 | Rtc Management Group, LLC | Substance Abuse Rehabilitation Facility | 1340 E Desert Cove Ave, Phoenix, AZ 85020-1110 | 2019-03-28 |
| 1780155077 | Pb Medical Group of Arizona, LLC | Substance Abuse Rehabilitation Facility | 3000 N 91st Ave, Phoenix, AZ 85037-4037 | 2018-12-11 |
| 1144790460 | Ebony House Inc | Substance Abuse Rehabilitation Facility | 6222 S. 13th Street, Phoenix, AZ 85042 | 2018-11-29 |
| 1891283149 | Bbc Whitton, LLC | Substance Abuse Rehabilitation Facility | 1106 E Whitton Ave, Phoenix, AZ 85014-5053 | 2018-04-23 |
| 1417456336 | Vogue Recovery Center, LLC | Substance Abuse Rehabilitation Facility | 4122 N 17th St, Phoenix, AZ 85016-5922 | 2018-02-06 |
| 1992254338 | A Path of Resilience | Substance Abuse Rehabilitation Facility | 6102 S 37th Ln, Phoenix, AZ 85041-5021 | 2016-09-27 |
| 1205380730 | Phoenix Oasis Recovery Homes Inc. | Substance Abuse Rehabilitation Facility | 5320 N 16th St Ste 102, Phoenix, AZ 85016-3241 | 2016-08-13 |
| Find all providers in PHOENIX | ||||
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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.