MEDICARE: ROCK VIEW RECOVERY I, LLC

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	324500000X	Substance Abuse Rehabilitation Facility
2	320800000X	Mental Illness Community Based Residential Treatment Facility

General Provider Information

NPI Number	:	1679380711
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	ROCK VIEW RECOVERY I, LLC

Provider Business Mailing Address
First Line	:	3120 W CAREFREE HWY STE 1-634
Second Line	:
City	:	PHOENIX
State	:	AZ
Zip	:	85086-3201
Country	:	US
Telephone Number	:	602-560-2252
Fax Number	:

Provider Business Practice Location Address
First Line	:	206 W ROCK VIEW RD
Second Line	:
City	:	PHOENIX
State	:	AZ
Zip	:	85085-4005
Country	:	US
Telephone Number	:	602-560-2252
Fax Number	:

Authorized Official
Title or Position	:	ADMINISTRATOR
Name	:	RYAN ROSS
Credential	:
Telephone Number	:	818-455-5003

Provider Enumeration Date	:	12/12/2024
Last Update Date	:	12/05/2025

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