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General NPI Number Information
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NPI Number | 1174410963
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Entity Type | Organization
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Legal Business Name | AWAKENING RECOVERY CENTER
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Dates
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Enumeration Date | 06/23/2025
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Last Update Date | 02/03/2026
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Provider Practice Location Address
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Address Line | 350 W SUPERSTITION BLVD STE. 119
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City | APACHE JUNCTION
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State | AZ
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Zip | 85120
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Country | US
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Telephone | 480-474-8797
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Fax | 480-982-7615
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Provider Business Mailing Address
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Address Line | 1204 E. BASLINE RD. STE. 208
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City | TEMPE
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State | AZ
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Zip | 85283
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Country | US
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Telephone | 480-209-1977
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Fax | 480-404-9716
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Authorized Official
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Title or Position | CEO
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Name | MR. SCOTT RICHARD PAYNE
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Credential | LISAC
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Telephone | 480-341-1644
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 324500000X
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Taxonomy Name | Substance Abuse Rehabilitation Facility
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 261QR0405X
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Taxonomy Name | Substance Use Disorder Rehabilitation Clinic/Center
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License Number |
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License Number State |
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