MEDICARE: PARTNERS IN RECOVERY, 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	261QM0850X	Adult Mental Health Clinic/Center

Medicare Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	Z135180	OTHER	AZ	MEDICARE PTAN

General Provider Information

NPI Number	:	1922232925
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	PARTNERS IN RECOVERY, LLC

Provider Business Mailing Address
First Line	:	924 N COUNTRY CLUB DR
Second Line	:
City	:	MESA
State	:	AZ
Zip	:	85201-4108
Country	:	US
Telephone Number	:	480-969-3800
Fax Number	:	480-644-1557

Provider Business Practice Location Address
First Line	:	10240 N 31ST AVE
Second Line	:	SUITE 101, 105, 109, 120, 200, 201, 218, 210A, 220
City	:	PHOENIX
State	:	AZ
Zip	:	85051-9558
Country	:	US
Telephone Number	:	480-969-3800
Fax Number	:	480-644-1557

Authorized Official
Title or Position	:	VP, REVENUE OPTIMIZATION
Name	:	JENNIFER ANN BARRETT
Credential	:
Telephone Number	:	480-969-3800

Provider Enumeration Date	:	05/06/2009
Last Update Date	:	08/28/2023

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