ROUNDSVILLE DRUG AND ALCOHOL TREATMENT OF ARIZONA


Address: 610 N Bagby Dr, Prescott, AZ 86301-2588
Phone: 9288482941

ROUNDSVILLE DRUG AND ALCOHOL TREATMENT OF ARIZONA (NPI# 1891300299) 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) 1891300299
Entity Type Organization
Organization Name ROUNDSVILLE DRUG AND ALCOHOL TREATMENT OF ARIZONA
Practice Address 610 N Bagby Dr
Prescott
AZ 86301-2588
Mailing Address 110 Rocky Dells Cir
Prescott
AZ 86303-5681
Practice Telephone 9288482941
Mailing Telephone 9284203214
Enumeration Date 2020-09-11
Last Update Date 2020-09-11
Authorized Official Name MICHAEL HARRISON COLCLASURE (OWNER)
Authorized Official Telephone 9284203214
Is Organization Subpart N

Taxonomy

Primary Taxonomy Code Classification License Number License State Taxonomy Group
Y 101YA0400X Counselor
Specialization: Addiction (Substance Use Disorder)
Behavioral Health & Social Service Providers

Other Provider/Organization Names

Other Name Type Code
A Sober Way To Recovery Doing Business As Name - Organization

Office Location

Street Address 610 N BAGBY DR
City PRESCOTT
State AZ
Zip Code 86301-2588

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Taxonomy Information

Taxonomy Code 101YA0400X
Grouping Behavioral Health & Social Service Providers
Classification Counselor
Specialization Addiction (Substance Use Disorder)

Taxonomy Definition

Definition to come...

Providers in the same taxonomy and city

NPI Name Taxonomy Address Enumeration
1619588209 Teri Sebastian Counselor 240 S Montezuma St Ste 201e, Prescott, AZ 86303-4712 2020-08-16
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1619527850 Taylor Counseling Services Taylor Tlc Counselor 1000 Ainsworth Dr Ste B215, Prescott, AZ 86305-3411 2019-09-19
1023527801 William James Bilbray Counselor 702 W Hillside Ave, Prescott, AZ 86301-1913 2017-09-25
1831583269 Renee Podraza Counselor 843 Miller Valley Rd Ste 203, Prescott, AZ 86301-1821 2015-03-24
1013314988 Mary Jo Fleming Counselor 919 12th Place Ste 13, Recovery In The Pines, Prescott, AZ 86301 2014-11-20
1891056461 Greta Blankman Stromberg Counselor 1320 W Gurley St, Prescott, AZ 86305-2854 2012-05-30
1982970034 Henry Dayton Turberville Counselor 214 N. Arizona Ave., Prescott, AZ 86301 2012-03-22
1578885257 Wesley Carl Kitchens Counselor 315 W Goodwin St, Prescott, AZ 86303 2010-02-22
1568608867 Robert Foster Steele Counselor 615 E. Gurley St, Ste D, Prescott, AZ 86301 2008-12-17
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Competitor

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City PRESCOTT
Zip Code 86301

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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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