Organization Active NPI

Fountain Hills Recovery, LLC

  • Substance Abuse Rehabilitation Facility
  • Fountain Hills, AZ
National Provider Identifier
1245772482
Registry record updated May 10, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Substance Abuse Rehabilitation FacilityTaxonomy code 324500000X
Legal business name
FOUNTAIN HILLS RECOVERY, LLC
Practice address
16872 E Avenue of the Fountains
Suite 204
Fountain Hills, AZ 85268-8312
Phone
(800) 715-2004
Fax
(480) 476-8901
NPI assigned
Nov 4, 2016
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 10, 2017

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

Authorized official

Name
John Salem
Title
Owner
Phone
(800) 715-2004

Specialties & licenses 1

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

Addresses

Primary practice location

16872 E Avenue of the Fountains
Suite 204
Fountain Hills, AZ 85268-8312

Mailing address

16872 E Avenue of the Fountains
Suite 204
Fountain Hills, AZ 85268-8312
Phone (800) 715-2004

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
03D2192870Fountain Hills Recovery16872 E Avenue of the Fountains, Suite 204, Fountain Hills, AZ 85268Certificate of waiverSep 14, 2026

National Provider Directory

National Provider Directory
Tax ID family
Fountain Hills Recovery 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.

Locations

16872 E Avenue of the Fountains
Ste 204
Fountain Hills, AZ 85268
Phone (800) 715-2004

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": "1478217600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1494374400000",
    "number": "1245772482",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "16872 E AVENUE OF THE FOUNTAINS",
            "address_2": "SUITE 204",
            "city": "FOUNTAIN HILLS",
            "state": "AZ",
            "postal_code": "852688312",
            "telephone_number": "800-715-2004",
            "fax_number": "480-476-8901"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "16872 E AVENUE OF THE FOUNTAINS",
            "address_2": "SUITE 204",
            "city": "FOUNTAIN HILLS",
            "state": "AZ",
            "postal_code": "852688312",
            "telephone_number": "800-715-2004",
            "fax_number": "480-476-8901"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FOUNTAIN HILLS RECOVERY, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-11-04",
        "last_updated": "2017-05-10",
        "status": "A",
        "authorized_official_last_name": "SALEM",
        "authorized_official_first_name": "JOHN",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "800-715-2004"
    },
    "taxonomies": [
        {
            "code": "324500000X",
            "taxonomy_group": "",
            "desc": "Substance Abuse Rehabilitation Facility",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fountain Hills, AZ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 10, 2017; 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.