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General NPI Number Information
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NPI Number | 1679444269
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Entity Type | Organization
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Legal Business Name | FOUR PILLARS RECOVERY LLC
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Dates
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Enumeration Date | 09/16/2025
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Last Update Date | 09/16/2025
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Provider Practice Location Address
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Address Line | 674 E WHITE MOUNTAIN BLVD SUITE 1
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City | PINETOP
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State | AZ
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Zip | 85935
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Country | US
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Telephone | 928-228-0776
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Fax | 480-240-9578
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Provider Business Mailing Address
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Address Line | PO BOX 141
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City | PINETOP
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State | AZ
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Zip | 85935-0141
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Country | US
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Telephone | 928-228-0776
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Fax | 480-240-9578
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Authorized Official
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Title or Position | OWNER
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Name | STEPHANIE RAY
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Credential |
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Telephone | 928-228-0776
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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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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