Healthcare Provider Details

I. General information

NPI: 1497616288
Provider Name (Legal Business Name): BEACON TREATMENT CENTER SHOW LOW
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/20/2025
Last Update Date: 09/24/2026
Certification Date: 09/24/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1201 E COOLEY ST STE ABC
SHOW LOW AZ
85901-5122
US

IV. Provider business mailing address

1201 E COOLEY ST STE ABC
SHOW LOW AZ
85901-5122
US

V. Phone/Fax

Practice location:
  • Phone: 928-251-2785
  • Fax: 928-251-2312
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QR0400X
TaxonomyRehabilitation Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: SARAH BURNETT
Title or Position: COO
Credential: BURNETT
Phone: 928-245-2940