Healthcare Provider Details

I. General information

NPI: 1851176895
Provider Name (Legal Business Name): VUIJON RECOVERY
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/28/2023
Last Update Date: 08/28/2023
Certification Date: 08/28/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

13100 S SUNLAND GIN RD STE 100
ARIZONA CITY AZ
85123-8659
US

IV. Provider business mailing address

4430 W ST KATERI DR
LAVEEN AZ
85339-6238
US

V. Phone/Fax

Practice location:
  • Phone: 858-603-8388
  • Fax: 602-916-1467
Mailing address:
  • Phone: 858-603-8388
  • Fax: 602-916-1467

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QM0850X
TaxonomyAdult Mental Health Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: ERIC M MACHARIA
Title or Position: ADMINISTRATOR
Credential:
Phone: 858-603-8388