Healthcare Provider Details

I. General information

NPI: 1881230886
Provider Name (Legal Business Name): BUENA VISTA RECOVERY, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/25/2019
Last Update Date: 08/26/2026
Certification Date: 08/26/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3033 S ARIZONA AVE
CHANDLER AZ
85248-2717
US

IV. Provider business mailing address

3033 S ARIZONA AVE
CHANDLER AZ
85248-2717
US

V. Phone/Fax

Practice location:
  • Phone: 480-716-5271
  • Fax: 480-716-5271
Mailing address:
  • Phone: 480-716-5271
  • Fax: 480-716-5271

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QC1800X
TaxonomyCorporate Health Clinic/Center
License Number
License Number StateNULL

VIII. Authorized Official

Name: BRITTANY ZIELINSKI
Title or Position: DIRECTOR OF BILLING
Credential:
Phone: 480-716-5271