NPIMap

Organization Active NPI

The Sanctuary at Sedona

  • Substance Abuse Rehabilitation Facility
  • Cornville, AZ
National Provider Identifier
1104379890
Registry record updated Jul 28, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Substance Abuse Rehabilitation FacilityTaxonomy code 324500000X
License
BH4797 Issued in AZ
Legal business name
THE SANCTUARY AT SEDONA
Practice address
2605 South Cactus Road
Cornville, AZ 86325
Phone
(928) 639-1300
Fax
(928) 639-1313
NPI assigned
Jul 28, 2016
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 28, 2016

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

Authorized official

Name
Mr. Dean Taraborelli
Title
Administrator
Phone
(928) 639-1300

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Substance Abuse Rehabilitation Facility 324500000X BH4797 AZ Primary

Addresses

Primary practice location

2605 South Cactus Road
Cornville, AZ 86325

Mailing address

2675 W State Route 89a
#1115
Sedona, AZ 86336-5240
Phone (928) 639-1300

National Provider Directory

National Provider Directory

Locations

2675 W State Route 89A
#1115
Sedona, AZ 86336

Practitioners & affiliated clinicians

Practitioners 1

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

NPI Registry JSON

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

{
    "created_epoch": "1469664000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1469664000000",
    "number": "1104379890",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2675 W STATE ROUTE 89A",
            "address_2": "#1115",
            "city": "SEDONA",
            "state": "AZ",
            "postal_code": "863365240",
            "telephone_number": "928-639-1300",
            "fax_number": "928-639-1313"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2605 SOUTH CACTUS ROAD",
            "city": "CORNVILLE",
            "state": "AZ",
            "postal_code": "86325",
            "telephone_number": "928-639-1300",
            "fax_number": "928-639-1313"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "THE SANCTUARY AT SEDONA",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-07-28",
        "last_updated": "2016-07-28",
        "status": "A",
        "authorized_official_last_name": "TARABORELLI",
        "authorized_official_first_name": "DEAN",
        "authorized_official_title_or_position": "ADMINISTRATOR",
        "authorized_official_telephone_number": "928-639-1300",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "324500000X",
            "taxonomy_group": "",
            "desc": "Substance Abuse Rehabilitation Facility",
            "state": "AZ",
            "license": "BH4797",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Cornville, AZ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 28, 2016; 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.