Park Place Recovery and Wellness Center LLC.

Primary specialty

Community/Behavioral Health AgencyTaxonomy code 251S00000X

Legal business name

PARK PLACE RECOVERY AND WELLNESS CENTER LLC.

Practice address

1350 E McKellips Rd Ste 2
Mesa, AZ 85203-2739

Phone

(623) 462-8187

NPI assigned

Aug 28, 2023

Organization subpart

No

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

Authorized official

Name

Mrs. Tara L Chase, LAC, MS, NCCNPI 1962127969

Title

Therapist

Phone

(623) 462-8187

Specialties & licenses 1

Addresses

Other names 1

• Park Place Recovery and Wellness Center LLC. Former legal business name

Tax ID family

Park Place Recovery and Wellness Center LLC2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

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

• Park Place Recovery and Wellness Center LLC

  • Mental Health Counselor
  • Surprise, AZ
  • NPI 1316712441
  NPD tax ID

Locations

Practitioners 1

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

• Tara Lynne Chase, LAC, MS, NCC

  • Mental Health Counselor
  • Mesa, AZ
  • NPI 1962127969

  Community/Behavioral Health

  NPD Authorized official

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

{
    "created_epoch": "1693180800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1693180800000",
    "number": "1013792118",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "13916 N 135TH DR",
            "city": "SURPRISE",
            "state": "AZ",
            "postal_code": "853798428",
            "telephone_number": "623-462-8187"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1350 E MCKELLIPS RD STE 2",
            "city": "MESA",
            "state": "AZ",
            "postal_code": "852032739",
            "telephone_number": "623-462-8187"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PARK PLACE RECOVERY AND WELLNESS CENTER LLC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-08-28",
        "last_updated": "2023-08-28",
        "certification_date": "2023-08-28",
        "status": "A",
        "authorized_official_last_name": "CHASE",
        "authorized_official_first_name": "TARA",
        "authorized_official_middle_name": "L",
        "authorized_official_title_or_position": "THERAPIST",
        "authorized_official_telephone_number": "623-462-8187",
        "authorized_official_name_prefix": "Mrs.",
        "authorized_official_credential": "LAC, MS, NCC"
    },
    "taxonomies": [
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Park Place Recovery and Wellness Center LLC.",
            "code": "4",
            "type": "Former Legal Business Name"
        }
    ]
}

• Tabitha C Parent-Buck, AU.D.
• George C Parides, DO
• Jeffrey Wayne Paris, M.S.
• Michelle Parisian, SLP
• Park Oriental Medicine Center, LLC (Park Oriental Medicine Center)
• Eun Soo Park
• Janie Park, RNFA
• Jimin Park, LAC
• Jiyea Park
• Kevin Park, DMD

• Community/Behavioral Health Agency in Mesa, AZ
• Providers in Mesa, AZ by specialty
• Community/Behavioral Health Agency in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 28, 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.