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General NPI Number Information
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NPI Number | 1922396639
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Entity Type | Organization
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Legal Business Name | SCOTTSDALE RECOVERY CENTER, LLC
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Dates
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Enumeration Date | 07/14/2011
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Last Update Date | 07/21/2022
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Provider Practice Location Address
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Address Line | 10446 N 74TH ST STE 150
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City | SCOTTSDALE
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State | AZ
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Zip | 85258-1045
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Country | US
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Telephone | 480-699-9044
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Fax | 480-284-6749
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Provider Business Mailing Address
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Address Line | 10446 N. 74TH ST. SUITE 150
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City | SCOTTSDALE
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State | AZ
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Zip | 85258
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Country | US
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Telephone | 480-699-9044
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Fax | 480-284-6749
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Authorized Official
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Title or Position | OWNER
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Name | MR. CHRIS COHN
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Credential |
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Telephone | 602-478-3210
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251S00000X
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Taxonomy Name | Community/Behavioral Health Agency
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License Number | OTC7795
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License Number State | AZ
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Taxonomy #2
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Taxonomy Code | 324500000X
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Taxonomy Name | Substance Abuse Rehabilitation Facility
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License Number | OTC7795
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License Number State | AZ
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