NPIMap

Organization Active NPI

Community Medical Services Arizona-Private, LLC

  • Methadone Clinic
  • Prescott Valley, AZ
National Provider Identifier
1457026460
Registry record updated Aug 26, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Methadone ClinicTaxonomy code 261QM2800X
Legal business name
COMMUNITY MEDICAL SERVICES ARIZONA-PRIVATE, LLC
Practice address
3155 N. Windsong Drive
Suites a and B
Prescott Valley, AZ 86314-2219
Phone
(928) 968-7400
Fax
(480) 687-7361
NPI assigned
Aug 11, 2021
Last updated
Aug 26, 2026By the provider in NPPES
Organization subpart
Yes
Parent organization
COMMUNITY MEDICAL SERVICES ARIZONA-PRIVATE, LLCAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Aug 26, 2026

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

Authorized official

Name
Nick Stavros
Title
Ceo
Phone
(602) 248-8886

Specialties & licenses 5

Specialty (taxonomy)CodeLicenseStatePrimary
Addiction (Substance Use Disorder) Counselor 101YA0400X
Mental Health Clinic/Center (Including Community Mental Health Center) 261QM0801X
Methadone Clinic 261QM2800X Primary
Substance Use Disorder Rehabilitation Clinic/Center 261QR0405X
Community/Behavioral Health Agency 251S00000X

Addresses

Primary practice location

3155 N. Windsong Drive
Suites a and B
Prescott Valley, AZ 86314-2219

Mailing address

8444 N 90TH St Ste 100
Scottsdale, AZ 85258-4437
Phone (480) 494-2497

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AZ
Opioid treatment program
Medicare-enrolled since Jan 1, 2020

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20200416000394 AZ Part B Supplier - Opioid Treatment Program (Otp) 1759711625 26 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Tucson, AZ; Yuma, AZ; Tempe, AZ; Sierra Vista, AZ; Show Low, AZ; Safford, AZ; Prescott Valley, AZ; Phoenix, AZ…

Other NPIs on the same Medicare enrollment 26

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

View all 26

National Provider Directory

National Provider Directory
Tax ID family
Communtiy Medical Services36 organizations share this tax ID, including this one
Part of
Communtiy Medical Services

Other organizations with this tax ID 35

Organizations that report the same tax identification number in the National Provider Directory.

View all 35

Locations

3155 N Windsong Dr
Prescott Valley, AZ 86314

3155 N Windsong Dr
Ste Ab
Prescott Valley, AZ 86314
Phone (928) 968-7400

Practitioners & affiliated clinicians

Practitioners 3

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": "1628640000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1787702400000",
    "number": "1457026460",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8444 N 90TH ST STE 100",
            "city": "SCOTTSDALE",
            "state": "AZ",
            "postal_code": "852584437",
            "telephone_number": "480-494-2497",
            "fax_number": "480-687-7361"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3155 N. WINDSONG DRIVE",
            "address_2": "SUITES A AND B",
            "city": "PRESCOTT VALLEY",
            "state": "AZ",
            "postal_code": "863142219",
            "telephone_number": "928-968-7400",
            "fax_number": "480-687-7361"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "COMMUNITY MEDICAL SERVICES ARIZONA-PRIVATE, LLC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "COMMUNITY MEDICAL SERVICES ARIZONA-PRIVATE, LLC",
        "enumeration_date": "2021-08-11",
        "last_updated": "2026-08-26",
        "certification_date": "2026-08-26",
        "status": "A",
        "authorized_official_last_name": "STAVROS",
        "authorized_official_first_name": "NICK",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "602-248-8886"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "261QM0801X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Mental Health (Including Community Mental Health Center)",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "261QM2800X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Methadone",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "261QR0405X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Rehabilitation, Substance Use Disorder",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Prescott Valley, AZ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 26, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.