SCOTTSDALE PROVIDENCE RECOVERY CENTER NPI 1821705104

NPI Information

NPI: 1821705104
Provider Name: SCOTTSDALE PROVIDENCE RECOVERY CENTER

Other Name: SCOTTSDALE PROVIDENCE RESIDENTIAL

Classification: Community Based Residential Treatment Facility, Mental Illness - 320800000X
Entity Type: Organization
Address:
9389 E VIA DEL SOL DR
SCOTTSDALE, AZ
ZIP 85255
Phone: (480) 284-7440
Get Directions

SCOTTSDALE PROVIDENCE RECOVERY CENTER is a community based residential treatment facility mental illness in Scottsdale, AZ. The provider is a home-like residential facility providing psychiatric treatment and psycho/social rehabilitative services to individuals diagnosed with mental illness. SCOTTSDALE PROVIDENCE RECOVERY CENTER NPI is 1821705104. The provider is registered as an organization entity type and is a multi-specialty group.
The provider Other Name Is Scottsdale Providence Residential.

The provider's business location address is:

9389 E VIA DEL SOL DR
SCOTTSDALE, AZ
ZIP 85255-072
Phone: (480) 284-7440
Fax: (480) 284-4178

The provider's authorized official is Daniel Joseph Nichols .
The authorized official title is Clinical Director and has the following contact phone number (602) 448-4055.

The enumeration date for this NPI number is 11/4/2022 and was last updated on 12/5/2022.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	Primary
1	101YM0800X	Counselor	Mental Health	No
2	261QM0850X	Clinic/Center	Adult Mental Health	No
3	261QM1300X	Clinic/Center	Multi-Specialty	No
4	261QR0405X	Clinic/Center	Rehabilitation, Substance Use Disorder	No
5	324500000X	Substance Abuse Rehabilitation Facility		No
6	320800000X	Community Based Residential Treatment Facility, Mental Illness		Yes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.	Other Provider Identifier	Other Provider Identifier Type	Other Provider Identifier State	Other Provider Identifier Issuer
1	BH8061	OTHER	ARIZONA	ADHS LICENSE

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 5/5/2024

NPI Synchronization or Removal

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