MEDICARE: REBUILDING LIVES STEP BY STEP

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	101YA0400X	Addiction (Substance Use Disorder) Counselor

General Provider Information

NPI Number	:	1194684597
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	REBUILDING LIVES STEP BY STEP

Provider Business Mailing Address
First Line	:	911 E TAYLOR ST
Second Line	:
City	:	PHOENIX
State	:	AZ
Zip	:	85006-3359
Country	:	US
Telephone Number	:	623-456-2793
Fax Number	:

Provider Business Practice Location Address
First Line	:	911 E TAYLOR ST
Second Line	:
City	:	PHOENIX
State	:	AZ
Zip	:	85006-3359
Country	:	US
Telephone Number	:	623-456-2793
Fax Number	:

Authorized Official
Title or Position	:	OWNER
Name	:	RACHELL SHANNON BROWN
Credential	:
Telephone Number	:	623-456-2793

Provider Enumeration Date	:	01/20/2026
Last Update Date	:	01/21/2026

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Directions to “REBUILDING LIVES STEP BY STEP ” Practice Location

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