Healthcare Provider Details

I. General information

NPI: 1235363235
Provider Name (Legal Business Name): PARTNERS IN RECOVERY, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/06/2009
Last Update Date: 01/06/2026
Certification Date: 01/06/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5222 E BASELINE RD SUITE 101
GILBERT AZ
85234-2963
US

IV. Provider business mailing address

924 N COUNTRY CLUB DR
MESA AZ
85201-4108
US

V. Phone/Fax

Practice location:
  • Phone: 602-258-1112
  • Fax: 602-252-0866
Mailing address:
  • Phone: 480-969-3800
  • Fax: 480-644-1557

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: KEN BROOKS
Title or Position: SR. DIRECTOR OF CONTRACT OPERATIONS
Credential:
Phone: 480-698-0203