MEDICARE: ACADIA REHABILITATION, LLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	224Z00000X	Occupational Therapy Assistant	OTC3883	AZ
2	2251C2600X	Cardiopulmonary Physical Therapist	OTC3883	AZ
3	225100000X	Physical Therapist	OTC3883	AZ

Medicare Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	Z034524	OTHER	AZ	MEDICARE ID-PIN

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
2	OTC3883	OTHER	AZ	OUTPATIENT TREATMENT CTR

General Provider Information

NPI Number	:	1750356523
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	ACADIA REHABILITATION, LLC

Provider Business Mailing Address
First Line	:	13260 N 94TH DR
Second Line	:	STE 205
City	:	PEORIA
State	:	AZ
Zip	:	85381-4240
Country	:	US
Telephone Number	:	623-583-6573
Fax Number	:	623-583-6571

Provider Business Practice Location Address
First Line	:	13260 N 94TH DR
Second Line	:	STE 205
City	:	PEORIA
State	:	AZ
Zip	:	85381-4240
Country	:	US
Telephone Number	:	623-583-6573
Fax Number	:	623-583-6571

Authorized Official
Title or Position	:	MANAGING MEMBER
Name	:	DR. WILLIAM HAAS
Credential	:	D.C.
Telephone Number	:	623-583-6573

Provider Enumeration Date	:	02/22/2006
Last Update Date	:	10/24/2007

Similar Medicare Providers

1144223561 — DR. WILLIAM M HAAS D.C.
Practice Location Address:

13260 N 94TH DR , SUITE 205
PEORIA, AZ
85381-4240

Practice Phone: 623-583-6570
Practice Fax: 623-583-6571

1679645691 — ACADIA HEALTH CLINIC, LLC
Practice Location Address:

13260 N 94TH DR , SUITE 205
PEORIA, AZ
85381-4240

Practice Phone: 623-583-6570
Practice Fax: 623-583-6571

1508057662 — ADVANCED DIAGNOSTICS NETWORK INC.
Practice Location Address:

13260 N 94TH DR STE 203
PEORIA, AZ
85381-4240

Practice Phone: 623-876-1860
Practice Fax:

1669669644 — WILLIAM M HAAS DBA ACADIA HEALTH CLINIC
Practice Location Address:

13260 N 94TH DR , SUITE 205
PEORIA, AZ
85381-4240

Practice Phone: 623-583-6570
Practice Fax: 623-583-6571

1770098311 — KIMBERLY A ELLIOTT LPCC
Practice Location Address:

8332 W THUNDERBIRD RD
PEORIA, AZ
85381-4822

Practice Phone: 928-707-9030
Practice Fax:

1841957412 — SHIONA MARIE SMITH PA-C
Practice Location Address:

15000 N 83RD AVE UNIT 200
PEORIA, AZ
85381-2002

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Practice Fax:

Directions to “ACADIA REHABILITATION, LLC ” Practice Location

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