Scottsdale Modern Detox LLC

Primary specialty

Substance Abuse Rehabilitation FacilityTaxonomy code 324500000X

Legal business name

SCOTTSDALE MODERN DETOX LLC

Doing business as

Scottsdale Detox

Practice address

7283 E Earll Dr BLDG B
Scottsdale, AZ 85251-7230

Phone

(480) 549-2220

NPI assigned

Dec 23, 2022

Organization subpart

No

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

Authorized official

Name

Quinn McCullough

Title

Ceo

Phone

(480) 466-8754

Specialties & licenses 2

Addresses

Other names 1

• Scottsdale Detox Doing business as

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

Locations

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

{
    "created_epoch": "1671753600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1672185600000",
    "number": "1437861259",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7904 E CHAPARRAL RD STE A110-473",
            "city": "SCOTTSDALE",
            "state": "AZ",
            "postal_code": "852507370"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7283 E EARLL DR BLDG B",
            "city": "SCOTTSDALE",
            "state": "AZ",
            "postal_code": "852517230",
            "telephone_number": "480-549-2220"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SCOTTSDALE MODERN DETOX LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-12-23",
        "last_updated": "2022-12-28",
        "certification_date": "2022-12-28",
        "status": "A",
        "authorized_official_last_name": "MCCULLOUGH",
        "authorized_official_first_name": "QUINN",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "480-466-8754"
    },
    "taxonomies": [
        {
            "code": "261QR0405X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Rehabilitation, Substance Use Disorder",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "324500000X",
            "taxonomy_group": "",
            "desc": "Substance Abuse Rehabilitation Facility",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Scottsdale Detox",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Scottsdale Detox",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Substance Abuse Rehabilitation Facility in Scottsdale, AZ
• Providers in Scottsdale, AZ by specialty
• Substance Abuse Rehabilitation Facility in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 28, 2022; 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.