NPIMap

Organization Active NPI

Haven Recovery Az LLC

  • Medical Specialty Clinic/Center
  • Glendale, AZ
National Provider Identifier
1396115234
Registry record updated Oct 5, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medical Specialty Clinic/CenterTaxonomy code 261QM2500X
Legal business name
HAVEN RECOVERY AZ LLC
Practice address
9524 W Camelback Rd
Ste C-130, #293
Glendale, AZ 85305-3104
Phone
(405) 834-2993
NPI assigned
Oct 5, 2015
Last updated
Oct 5, 2015By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 5, 2015

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

Authorized official

Name
Erich BrueschkeNPI 1265740880
Title
Member
Phone
(405) 834-2993

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Medical Specialty Clinic/Center 261QM2500X NU Primary

Addresses

Primary practice location

9524 W Camelback Rd
Ste C-130, #293
Glendale, AZ 85305-3104

Mailing address

9524 W Camelback Rd
Ste C-130, #293
Glendale, AZ 85305-3104

National Provider Directory

National Provider Directory

Locations

9524 W Camelback Rd
Ste C130
Glendale, AZ 85305
Phone (405) 834-2993

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1444003200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1444003200000",
    "number": "1396115234",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9524 W CAMELBACK RD",
            "address_2": "STE C-130, #293",
            "city": "GLENDALE",
            "state": "AZ",
            "postal_code": "853053104"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9524 W CAMELBACK RD",
            "address_2": "STE C-130, #293",
            "city": "GLENDALE",
            "state": "AZ",
            "postal_code": "853053104",
            "telephone_number": "405-834-2993"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HAVEN RECOVERY AZ LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-10-05",
        "last_updated": "2015-10-05",
        "status": "A",
        "authorized_official_last_name": "BRUESCHKE",
        "authorized_official_first_name": "ERICH",
        "authorized_official_title_or_position": "MEMBER",
        "authorized_official_telephone_number": "405-834-2993"
    },
    "taxonomies": [
        {
            "code": "261QM2500X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Medical Specialty",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Glendale, AZ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 5, 2015; 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.