Healthcare Provider Details

I. General information

NPI: 1174410963
Provider Name (Legal Business Name): AWAKENING RECOVERY CENTER
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/23/2025
Last Update Date: 02/03/2026
Certification Date: 02/03/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

350 W SUPERSTITION BLVD STE. 119
APACHE JUNCTION AZ
85120
US

IV. Provider business mailing address

1204 E. BASLINE RD. STE. 208
TEMPE AZ
85283
US

V. Phone/Fax

Practice location:
  • Phone: 480-474-8797
  • Fax: 480-982-7615
Mailing address:
  • Phone: 480-209-1977
  • Fax: 480-404-9716

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code324500000X
TaxonomySubstance Abuse Rehabilitation Facility
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code261QR0405X
TaxonomySubstance Use Disorder Rehabilitation Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: MR. SCOTT RICHARD PAYNE
Title or Position: CEO
Credential: LISAC
Phone: 480-341-1644