Healthcare Provider Details

I. General information

NPI: 1518668235
Provider Name (Legal Business Name): EMBARK RECOVERY, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/10/2023
Last Update Date: 12/04/2025
Certification Date: 12/04/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7900 E GREENWAY RD STE 214
SCOTTSDALE AZ
85260-1715
US

IV. Provider business mailing address

PO BOX 12341
GLENDALE AZ
85318-2341
US

V. Phone/Fax

Practice location:
  • Phone: 877-215-2224
  • Fax: 877-215-2224
Mailing address:
  • Phone: 623-764-3476
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code261QR0405X
TaxonomySubstance Use Disorder Rehabilitation Clinic/Center
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code261QM0801X
TaxonomyMental Health Clinic/Center (Including Community Mental Health Center)
License Number
License Number State

VIII. Authorized Official

Name: DAVID SLATTERY
Title or Position: MANAGER
Credential:
Phone: 877-215-2224