Round Table Recovery, LLC

Primary specialty

Community/Behavioral Health AgencyTaxonomy code 251S00000X

Legal business name

ROUND TABLE RECOVERY, LLC

Practice address

711 S Granite St
Suite B
Prescott, AZ 86303-4241

Phone

(928) 533-2887

Fax

(928) 776-4781

NPI assigned

Jul 22, 2011

Organization subpart

No

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

Authorized official

Name

Ira N Nishikawa

Title

Director

Phone

(928) 533-2887

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1311292800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1311292800000",
    "number": "1316225444",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "711 S GRANITE ST",
            "address_2": "SUITE B",
            "city": "PRESCOTT",
            "state": "AZ",
            "postal_code": "863034241",
            "telephone_number": "928-533-2887",
            "fax_number": "928-776-4781"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "711 S GRANITE ST",
            "address_2": "SUITE B",
            "city": "PRESCOTT",
            "state": "AZ",
            "postal_code": "863034241",
            "telephone_number": "928-533-2887",
            "fax_number": "928-776-4781"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ROUND TABLE RECOVERY, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-07-22",
        "last_updated": "2011-07-22",
        "status": "A",
        "authorized_official_last_name": "NISHIKAWA",
        "authorized_official_first_name": "IRA",
        "authorized_official_middle_name": "N",
        "authorized_official_title_or_position": "DIRECTOR",
        "authorized_official_telephone_number": "928-533-2887"
    },
    "taxonomies": [
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Naomi Wendy Rosenberg, RPH
• Rebecca Ross, APRN, FNP-C
• Beth Rossi, LCSW
• Franklin J Roth, M.D.
• Douglas Wayne Rothrock, M.D.
• Alexis Danae Rounds, MD
• Roundsville Drug and Alcohol Treatment of Arizona
• Andrew J Rounseville, MD
• Jack William Routson, MD
• Royal Az LLC

• Community/Behavioral Health Agency in Prescott, AZ
• Providers in Prescott, AZ by specialty
• Community/Behavioral Health Agency in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 22, 2011; 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.