The River Source Treatment Center Casa Grande, LLC

Primary specialty

Substance Abuse Rehabilitation FacilityTaxonomy code 324500000X

Legal business name

THE RIVER SOURCE TREATMENT CENTER CASA GRANDE, LLC

Practice address

16286 S Sunland Gin Rd
Arizona City, AZ 85123-6196

Phone

(888) 687-7332

NPI assigned

Jan 20, 2009

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Tina Lee

Title

Finance Director

Phone

(520) 582-4718

Specialties & licenses 3

Addresses

Other identifiers 3

Tax ID family

The River Source Treatment Center Casa Grande LLC5 organizations share this tax ID, including this one

Other organizations with this tax ID 4

Organizations that report the same tax identification number in the National Provider Directory.

• The River Source Treatment Center Casa Grande, LLC

  • Addiction Psychiatry Physician
  • Phoenix, AZ
  • NPI 1447946330
  NPD tax ID
• The River Source Treatment Center Casa Grande, LLC

  • Substance Abuse Rehabilitation Facility
  • Arizona City, AZ
  • NPI 1487367314
  NPD tax ID
• The River Source Treatment Center Casa Grande, LLC

  • Addiction (Substance Use Disorder) Psychologist
  • Arizona City, AZ
  • NPI 1568243103
  NPD tax ID
• The River Source Treatment Center Casa Grande, LLC

  • Children's Substance Abuse Rehabilitation Facility
  • Gilbert, AZ
  • NPI 1851004220
  NPD tax ID

Locations

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Natalie Summit, LPC

  • Professional Counselor
  • Gilbert, AZ
  • NPI 1548826258
  NPD (past)
• Paul Raymund Valbuena, MD

  • Psychiatry Physician
  • Scottsdale, AZ
  • NPI 1902009145
  NPD (past)
• Safdar I Chaudhary, MD

  • Psychiatry Physician
  • Eagleville, PA
  • NPI 1225042401
  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1232409600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1686700800000",
    "number": "1003053570",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 4293",
            "city": "ARIZONA CITY",
            "state": "AZ",
            "postal_code": "851232669",
            "telephone_number": "888-687-7332"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "16286 S SUNLAND GIN RD",
            "city": "ARIZONA CITY",
            "state": "AZ",
            "postal_code": "851236196",
            "telephone_number": "888-687-7332"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2325 W Guadalupe Rd Ste 107",
            "address_purpose": "LOCATION",
            "city": "Gilbert",
            "state": "AZ",
            "postal_code": "852332811",
            "country_code": "US",
            "telephone_number": "480-298-7301",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "7910 W Thomas Rd",
            "address_purpose": "LOCATION",
            "city": "Phoenix",
            "state": "AZ",
            "postal_code": "850334830",
            "country_code": "US",
            "telephone_number": "866-370-8656",
            "fax_number": "520-416-5944",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "THE RIVER SOURCE TREATMENT CENTER CASA GRANDE, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-01-20",
        "last_updated": "2023-06-14",
        "certification_date": "2023-06-14",
        "status": "A",
        "authorized_official_last_name": "LEE",
        "authorized_official_first_name": "TINA",
        "authorized_official_title_or_position": "FINANCE DIRECTOR",
        "authorized_official_telephone_number": "520-582-4718"
    },
    "taxonomies": [
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "320800000X",
            "taxonomy_group": "",
            "desc": "Community Based Residential Treatment Facility, Mental Illness",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "324500000X",
            "taxonomy_group": "",
            "desc": "Substance Abuse Rehabilitation Facility",
            "state": "AZ",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "JOINT COMMISSION",
            "identifier": "496790",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AZDHS",
            "identifier": "IFB6615",
            "state": "AZ"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AZDHS - GILBERT LOCATION",
            "identifier": "OTC9325",
            "state": "AZ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Samuel Efrain Sanchez, D.O.
• Seabreeze Haven Counseling LLC
• Manon Tabak
• Tailor Made Non-Medical Homecare LLC
• Brigitt Deanne Taylor
• The River Source Treatment Center Casa Grande, LLC
• The River Source Treatment Center Casa Grande, LLC
• Jill R Unruh, LPC
• Valley Cardiothoracics PLLC
• Vuijon Recovery

• Substance Abuse Rehabilitation Facility in Arizona City, AZ
• Providers in Arizona City, AZ by specialty
• Substance Abuse Rehabilitation Facility in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 14, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.