Prescott Recovery Services LLC

Primary specialty

Substance Abuse Rehabilitation FacilityTaxonomy code 324500000X

Legal business name

PRESCOTT RECOVERY SERVICES LLC

Practice address

805 White Spar Rd
Prescott, AZ 86303-4636

Phone

(928) 899-8105

Fax

(866) 697-2326

NPI assigned

Dec 17, 2019

Organization subpart

No

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

Authorized official

Name

Debra Kimbro

Title

Director of Finance

Phone

(706) 633-3384

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1576540800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1576540800000",
    "number": "1104464544",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "805 WHITE SPAR RD",
            "city": "PRESCOTT",
            "state": "AZ",
            "postal_code": "863034636"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "805 WHITE SPAR RD",
            "city": "PRESCOTT",
            "state": "AZ",
            "postal_code": "863034636",
            "telephone_number": "928-899-8105",
            "fax_number": "866-697-2326"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PRESCOTT RECOVERY SERVICES LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-12-17",
        "last_updated": "2019-12-17",
        "certification_date": "2019-12-17",
        "status": "A",
        "authorized_official_last_name": "KIMBRO",
        "authorized_official_first_name": "DEBRA",
        "authorized_official_title_or_position": "DIRECTOR OF FINANCE",
        "authorized_official_telephone_number": "706-633-3384"
    },
    "taxonomies": [
        {
            "code": "324500000X",
            "taxonomy_group": "",
            "desc": "Substance Abuse Rehabilitation Facility",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Substance Abuse Rehabilitation Facility in Prescott, AZ
• Providers in Prescott, 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 Dec 17, 2019; 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.