PHOENIX ADDICTION RECOVERY LLC


Address: 4135 S Power Rd Ste 113, Mesa, AZ 85212-3625
Phone: 6025018097

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).

Provider Overview

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

Taxonomy

Primary Taxonomy Code Classification License Number License State Taxonomy Group
Y 261QR0405X Clinic/Center
Specialization: Rehabilitation, Substance Use Disorder
Ambulatory Health Care Facilities

Other Provider/Organization Names

Other Name Type Code
PAR Doing Business As Name - Organization

Office Location

Street Address 4135 S POWER RD STE 113
City MESA
State AZ
Zip Code 85212-3625

Providers in the same location

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

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Taxonomy Information

Taxonomy Code 261QR0405X
Grouping Ambulatory Health Care Facilities
Classification Clinic/Center
Specialization Rehabilitation, Substance Use Disorder

Taxonomy Definition

Definition to come...

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1437617958 Choice Recovery Center, LLC Clinic/Center 2222 S Dobson Rd Ste 1002, Mesa, AZ 85202-6200 2019-03-04
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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
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Competitor

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City MESA
Zip Code 85212

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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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