NPIMap

Organization Active NPI

Partners in Recovery, LLC

  • Adult Mental Health Clinic/Center
  • Wickenburg, AZ
National Provider Identifier
1205060100
Registry record updated Sep 30, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Adult Mental Health Clinic/CenterTaxonomy code 261QM0850X
Legal business name
PARTNERS IN RECOVERY, LLC
Practice address
811 N Tegner St.
Suite 121 & 123 & 125
Wickenburg, AZ 85390-2268
Phone
(480) 969-3800
Fax
(480) 644-1557
NPI assigned
May 6, 2009
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 30, 2024

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

Authorized official

Name
Kenneth Brooks
Title
RCM
Phone
(480) 969-3800

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Adult Mental Health Clinic/Center 261QM0850X Primary

Addresses

Primary practice location

811 N Tegner St.
Suite 121 & 123 & 125
Wickenburg, AZ 85390-2268

Mailing address

924 N Country Club Dr
Mesa, AZ 85201-4108
Phone (480) 969-3800

Other identifiers 1

IdentifierTypeStateIssuer
Z135180OtherAZMEDICARE PTAN

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AZ

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20100203000179 AZ Part B Supplier - Clinic/Group Practice 9638212301 Receives reassigned benefits from 64 practitioners
15 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Wickenburg, AZ; Phoenix, AZ; Peoria, AZ; Lakeside, AZ; Glendale, AZ; Gilbert, AZ; Mesa, AZ

Other NPIs on the same Medicare enrollment 15

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

View all 15

National Provider Directory

National Provider Directory
Tax ID family
Partners in Recovery LLC17 organizations share this tax ID, including this one

Other organizations with this tax ID 16

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

View all 16

Locations

5222 E Baseline Rd
Ste 101
Gilbert, AZ 85234
Phone (480) 659-0202

10240 N 31st Ave
Ste 101
Phoenix, AZ 85051
Phone (602) 395-1700

811 N Tegner St
Ste 121
Wickenburg, AZ 85390
Phone (928) 684-0600

Practitioners & affiliated clinicians

Practitioners 22

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

View all 22

NPI Registry JSON

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

{
    "created_epoch": "1241568000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1727654400000",
    "number": "1205060100",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "924 N COUNTRY CLUB DR",
            "city": "MESA",
            "state": "AZ",
            "postal_code": "852014108",
            "telephone_number": "480-969-3800",
            "fax_number": "480-644-1557"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "811 N TEGNER ST.",
            "address_2": "SUITE 121 & 123 & 125",
            "city": "WICKENBURG",
            "state": "AZ",
            "postal_code": "853902268",
            "telephone_number": "480-969-3800",
            "fax_number": "480-644-1557"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PARTNERS IN RECOVERY, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-05-06",
        "last_updated": "2024-09-30",
        "certification_date": "2024-09-30",
        "status": "A",
        "authorized_official_last_name": "BROOKS",
        "authorized_official_first_name": "KENNETH",
        "authorized_official_title_or_position": "RCM",
        "authorized_official_telephone_number": "480-969-3800"
    },
    "taxonomies": [
        {
            "code": "261QM0850X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Adult Mental Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE PTAN",
            "identifier": "Z135180",
            "state": "AZ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Wickenburg, AZ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 30, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.