Healthcare Provider Details

I. General information

NPI: 1679380711
Provider Name (Legal Business Name): ROCK VIEW RECOVERY I, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/12/2024
Last Update Date: 12/05/2025
Certification Date: 12/05/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

206 W ROCK VIEW RD
PHOENIX AZ
85085-4005
US

IV. Provider business mailing address

3120 W CAREFREE HWY STE 1-634
PHOENIX AZ
85086-3201
US

V. Phone/Fax

Practice location:
  • Phone: 602-560-2252
  • Fax:
Mailing address:
  • Phone: 602-560-2252
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code320800000X
TaxonomyMental Illness Community Based Residential Treatment Facility
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code324500000X
TaxonomySubstance Abuse Rehabilitation Facility
License Number
License Number State

VIII. Authorized Official

Name: RYAN ROSS
Title or Position: ADMINISTRATOR
Credential:
Phone: 818-455-5003