PHOENIX ADDICTION RECOVERY LLC (NPI# 1598235665) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
Nation Provider ID (NPI) | 1598235665 |
Entity Type | Organization |
Organization Name | PHOENIX ADDICTION RECOVERY LLC |
Practice Address |
4135 S Power Rd Ste 113 Mesa AZ 85212-3625 |
Mailing Address |
1839 E Mallory St Mesa AZ 85203-1329 |
Practice Telephone | 6025018097 |
Mailing Telephone | 6025018097 |
Enumeration Date | 2018-11-30 |
Last Update Date | 2018-11-30 |
Authorized Official Name | STEPHEN POTHIER (OWNER) |
Authorized Official Telephone | 6025018097 |
Is Organization Subpart | N |
Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
---|---|---|---|---|---|
Y | 261QR0405X |
Clinic/Center Specialization: Rehabilitation, Substance Use Disorder |
Ambulatory Health Care Facilities |
Other Name | Type Code |
---|---|
PAR | Doing Business As Name - Organization |
Street Address |
4135 S POWER RD STE 113 |
City | MESA |
State | AZ |
Zip Code | 85212-3625 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1689876252 | Douglas Milan Maready | Internal Medicine | 4135 S Power Rd Ste 113, Mesa, AZ 85212-3625 | 2007-06-05 |
1528578515 | Bret L. Lopez | Internal Medicine | 4135 S Power Rd Ste 113, Mesa, AZ 85212-3625 | 2017-10-04 |
1255860342 | Doug Maready Md Pllc | Internal Medicine | 4135 S Power Rd Ste 113, Mesa, AZ 85212-3625 | 2017-06-12 |
1043608052 | Karen Louise Wilsman | Nurse Practitioner | 4135 S Power Rd Ste 113, Mesa, AZ 85212-3625 | 2014-12-27 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1922610302 | West Point Optical Group | Optometrist | 10706 E Point Twenty-two Blvd, #107, Mesa, AZ 85212 | 2020-08-18 |
1215553565 | Andrew Eugene Pak | Dentist | 10664 East Point Twenty-two Blvd, Mesa, AZ 85212 | 2020-06-23 |
1588200265 | Signal Butte Kids Dentistry and Orthodontics, LLP | Dentist | 10664 E. Point Twenty Two Blvd, Mesa, AZ 85212 | 2019-11-18 |
1194371526 | Safeway Inc | Durable Medical Equipment & Medical Supplies | 4316 S Signal Butte Rd, Mesa, AZ 85212 | 2019-08-12 |
1194200980 | Highbury Dental Management, LLC | Dentist | 4425 S Mountain Rd, Suite 109, Mesa, AZ 85212 | 2018-09-27 |
1033623541 | Latanya Olivia Edenburgs | Case Manager/Care Coordinator | 10436 E Radiant Ave., Mesa, AZ 85212 | 2017-11-20 |
1205355880 | Linda Okafor | Nurse Practitioner | 4719 S Calderon Circle, Mesa, AZ 85212 | 2017-09-14 |
1689121188 | Agh Mesa LLC | General Acute Care Hospital | 9130 East Elliot Road, Mesa, AZ 85212 | 2016-09-01 |
1861841918 | Ryan Blake | Dentist | 4425 S. Mountain Road, Ste 109, Mesa, AZ 85212 | 2016-06-09 |
1083089460 | White Glove Health | Nurse Practitioner | 2906 S Lynch Cr, Mesa, AZ 85212 | 2015-12-10 |
Find all providers in zip 85212 |
Taxonomy Code | 261QR0405X |
Grouping | Ambulatory Health Care Facilities |
Classification | Clinic/Center |
Specialization | Rehabilitation, Substance Use Disorder |
Definition to come... |
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1154940864 | Light House Group Home LLC | Clinic/Center | 108 E 2nd Ave Ste 101, Mesa, AZ 85210-1410 | 2020-04-13 |
1871128520 | Summit Bhc Mesa LLC | Clinic/Center | 860 N Center St Bldg 1-3, Mesa, AZ 85201-4201 | 2020-03-03 |
1861025876 | Summit Bhc Mesa LLC | Clinic/Center | 846 North Center Street Suite 101, Mesa, AZ 85201 | 2020-02-18 |
1437617958 | Choice Recovery Center, LLC | Clinic/Center | 2222 S Dobson Rd Ste 1002, Mesa, AZ 85202-6200 | 2019-03-04 |
1851740898 | Evolution Way | Clinic/Center | 724 W University Dr, Suite 103, Mesa, AZ 85201-5649 | 2016-06-10 |
1437213725 | Community Bridges | Clinic/Center | 554 S Bellview, Mesa, AZ 85204-2504 | 2006-12-20 |
1518923168 | Curtis Walling, Phd PC | Clinic/Center | 3660 E University Dr, Mesa, AZ 85205-6960 | 2006-04-24 |
1841752581 | Crossroads, Inc. Red Mountain | Clinic/Center | 143 S Center St, Mesa, AZ 85210-1307 | 2019-04-02 |
1144670951 | Soba Mesa LLC | Clinic/Center | 6262 E Broadway Rd, Mesa, AZ 85206-6101 | 2016-06-13 |
1861853756 | Archways Recovery Centers, LLC | Clinic/Center | 2222 S Dobson Rd, Suite 1002, Mesa, AZ 85202-6481 | 2016-03-18 |
Find all providers in MESA |
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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.