Park Place Recovery and Wellness Center LLC

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

Legal business name

PARK PLACE RECOVERY AND WELLNESS CENTER LLC

Practice address

13916 N 135TH Dr
Surprise, AZ 85379-8428

Phone

(623) 462-8187

NPI assigned

Nov 20, 2023

Organization subpart

No

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

Authorized official

Name

Tara L Chase, LAC, MSNPI 1962127969

Title

Ceo

Phone

(623) 462-8187

Specialties & licenses 1

Addresses

Tax ID family

Park Place Recovery and Wellness Center 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.

• Park Place Recovery and Wellness Center LLC.

  • Community/Behavioral Health Agency
  • Mesa, AZ
  • NPI 1013792118
  NPD tax ID

Practitioners 1

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

• Tara Lynne Chase, LAC, MS, NCC

  • Mental Health Counselor
  • Mesa, AZ
  • NPI 1962127969
  NPD Authorized official

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

{
    "created_epoch": "1700438400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1700438400000",
    "number": "1316712441",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "13916 N 135TH DR",
            "city": "SURPRISE",
            "state": "AZ",
            "postal_code": "853798428"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "13916 N 135TH DR",
            "city": "SURPRISE",
            "state": "AZ",
            "postal_code": "853798428",
            "telephone_number": "623-462-8187"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PARK PLACE RECOVERY AND WELLNESS CENTER LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-11-20",
        "last_updated": "2023-11-20",
        "certification_date": "2023-11-18",
        "status": "A",
        "authorized_official_last_name": "CHASE",
        "authorized_official_first_name": "TARA",
        "authorized_official_middle_name": "L",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "623-462-8187",
        "authorized_official_credential": "LAC, MS"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jordan David Panchu
• Sushil Raj Pandey, MD
• Kinying Connie Pang
• Paradise for Parents Quality Care,LLC
• Paragon Management, Inc.
• Grace Park, D.D.S
• Amber Lelia Parker, RN, BSN, IBCLC
• Shaqise Parker
• Susan Quattrini Parmenter, FNP
• Justine Ann Rosarda Pasillas, DPT

• Mental Health Counselor in Surprise, AZ
• Providers in Surprise, AZ by specialty
• Mental Health Counselor in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 20, 2023; 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.