MEDICARE: INTENSIVE TREATMENT SYSTEMS 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	208D00000X	General Practice Physician
2	251S00000X	Community/Behavioral Health Agency	BH 2623	AZ

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	AZ10081M	OTHER	AZ	FDA
2	955023	OTHER	AZ	AHCCCS

General Provider Information

NPI Number	:	1811073059
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	INTENSIVE TREATMENT SYSTEMS LLC

Provider Business Mailing Address
First Line	:	19401 N CAVE CREEK RD
Second Line	:
City	:	PHOENIX
State	:	AZ
Zip	:	85024-1801
Country	:	US
Telephone Number	:	602-996-0105
Fax Number	:	602-996-1915

Provider Business Practice Location Address
First Line	:	19401 N CAVE CREEK RD
Second Line	:
City	:	PHOENIX
State	:	AZ
Zip	:	85024-1801
Country	:	US
Telephone Number	:	602-996-0099
Fax Number	:	602-996-1915

Authorized Official
Title or Position	:	DIRECTOR OF OPERATIONS
Name	:	DANIELLA SABUR
Credential	:
Telephone Number	:	602-576-8651

Provider Enumeration Date	:	10/31/2006
Last Update Date	:	11/21/2025

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