Organization · Type 2 NPI

Scottsdale Providence Recovery Center

Mental Illness Community Based Residential Treatment Facility · Scottsdale, AZ

NPI number 1821705104 Active

Practice location

9389 E Via Del Sol Dr
Scottsdale, AZ 85255-5072

Call (480) 284-7440 Map

Fax (480) 284-4178

Mailing address

8889 E Via Linda
Scottsdale, AZ 85258-5420

Specialties and licenses

Taxonomy	Code	License
Mental Health Counselor	101YM0800X	None listed
Adult Mental Health Clinic/Center	261QM0850X	None listed
Multi-Specialty Clinic/Center	261QM1300X	None listed
Substance Use Disorder Rehabilitation Clinic/Center	261QR0405X	None listed
Mental Illness Community Based Residential Treatment Facility Primary	320800000X	None listed
Substance Abuse Rehabilitation Facility	324500000X	None listed

Mental Illness Community Based Residential Treatment Facility: A home-like residential facility providing psychiatric treatment and psycho/social rehabilitative services to individuals diagnosed with mental illness.

Another provider at this address

Andrew David Parker, LMSWClinical Social Worker Scottsdale, AZ NPI 1437928769

Other mental illness community based residential treatment facility providers in Scottsdale

See all in Scottsdale →

NPI record

NPI: 1821705104
Entity type: Organization (Type 2)
Issued: Nov 4, 2022
Last updated: Dec 5, 2022
Status: Active
Subpart: Yes of Scottsdale Providence Recovery Center

Other names

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Scottsdale Providence Residential Center · doing business as
Scottsdale Providence Residential · other name
Scottsdale Providence Residential · other name

Authorized official

Daniel Joseph Nichols, LCSW
Clinical Director
(602) 448-4055

Verify this record

This page mirrors the public NPPES file. For credentialing or billing, confirm it on the official CMS NPI Registry, and check the license with the state board.

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About NPI 1821705104

Scottsdale Providence Recovery Center's National Provider Identifier is 1821705104, issued on Nov 4, 2022. The primary taxonomy on file is Mental Illness Community Based Residential Treatment Facility (320800000X), and the practice location is in Scottsdale, AZ. The record was last updated on Dec 5, 2022.