Organization Active NPI

Camelback Recovery Treatment Center

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Phoenix, AZ
National Provider Identifier
1043963440
Registry record updated Mar 7, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health Clinic/Center (Including Community Mental Health Center)Taxonomy code 261QM0801X
Legal business name
CAMELBACK RECOVERY TREATMENT CENTER
Practice address
4527 N 16TH St Ste 200
Phoenix, AZ 85016-5354
Phone
(760) 835-7562
NPI assigned
Jan 27, 2022
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 7, 2022

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

Authorized official

Name
Christopher Newman
Title
Coo
Phone
(760) 835-7562

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Clinic/Center (Including Community Mental Health Center) 261QM0801X Primary
Substance Use Disorder Rehabilitation Clinic/Center 261QR0405X

Addresses

Primary practice location

4527 N 16TH St Ste 200
Phoenix, AZ 85016-5354

Mailing address

4340 E Indian School Rd Ste 21-237
Phoenix, AZ 85018-5392

Other names 1

  • Camelback Recovery Doing business as

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
03D2254707Camelback Recovery Treatment Center4527 N 16TH St Ste 200, Phoenix, AZ 85016Certificate of waiverMar 6, 2028

National Provider Directory

National Provider Directory

Locations

4340 E Indian School Rd
Ste 21237
Phoenix, AZ 85018

Ownership & related parties

Subparts reporting this organization as parent 1

Organizations that report themselves as subparts in NPPES and name this organization, in the same state, as their parent.

NPI Registry JSON

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

{
    "created_epoch": "1643241600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1646611200000",
    "number": "1043963440",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4340 E INDIAN SCHOOL RD STE 21-237",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850185392"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4527 N 16TH ST STE 200",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850165354",
            "telephone_number": "760-835-7562"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CAMELBACK RECOVERY TREATMENT CENTER",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-01-27",
        "last_updated": "2022-03-07",
        "certification_date": "2022-03-07",
        "status": "A",
        "authorized_official_last_name": "NEWMAN",
        "authorized_official_first_name": "CHRISTOPHER",
        "authorized_official_title_or_position": "COO",
        "authorized_official_telephone_number": "760-835-7562"
    },
    "taxonomies": [
        {
            "code": "261QM0801X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Mental Health (Including Community Mental Health Center)",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "261QR0405X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Rehabilitation, Substance Use Disorder",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Camelback Recovery",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Phoenix, AZ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 7, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.