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General NPI Number Information
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NPI Number | 1891467684
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Entity Type | Organization
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Legal Business Name | REGENCY RECOVERY AND WELLNESS CENTER
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Dates
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Enumeration Date | 09/30/2021
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Last Update Date | 06/01/2023
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Provider Practice Location Address
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Address Line | 1301 E GURLEY ST UNIT A
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City | PRESCOTT
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State | AZ
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Zip | 86301-3313
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Country | US
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Telephone | 928-460-7001
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Fax | 928-277-0804
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Provider Business Mailing Address
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Address Line | 340 ROBINSON DR UNIT D
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City | PRESCOTT
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State | AZ
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Zip | 86303-3320
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Country | US
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Telephone | 928-460-7001
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Fax | 928-277-0804
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Authorized Official
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Title or Position | PRESIDENT
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Name | NICHOLAS SPANIAK
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Credential |
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Telephone | 949-630-5253
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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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