Organization Active NPI

Project Recovery of Arizona, Inc.

  • Integrative Medicine Physician
  • Tucson, AZ
National Provider Identifier
1639857196
Registry record updated Nov 11, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Integrative Medicine PhysicianTaxonomy code 202D00000X
Legal business name
PROJECT RECOVERY OF ARIZONA, INC.
Practice address
3438 N Country Club Rd
Tucson, AZ 85716-1257
Phone
(520) 286-9964
NPI assigned
Jul 6, 2023
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 11, 2025

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

Authorized official

Name
Charles Jackson
Title
Cco
Phone
(480) 787-1591

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Integrative Medicine PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 202D00000X Primary
Substance Use Disorder Rehabilitation Clinic/Center 261QR0405X
Substance Abuse Rehabilitation Facility 324500000X

Addresses

Primary practice location

3438 N Country Club Rd
Tucson, AZ 85716-1257

Mailing address

3438 N Country Club Rd
Tucson, AZ 85716-1257
Phone (520) 286-9964

Other names 1

  • NOVA VIA TUCSON Doing business as

Laboratory certificates & supplier records

Derived by NPIMap

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

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
03D2330997Project Recovery of Arizona Dba Nova Via Tucson3438 N Country Club Rd, Tucson, AZ 85716Certificate of waiverSep 23, 2027

National Provider Directory

National Provider Directory

Locations

4600 E Washington St
Ste 3003080
Phoenix, AZ 85034

3438 N Country Club Rd
Tucson, AZ 85716
Phone (520) 531-1040

3438 N Country Club Rd
Fl 1
Tucson, AZ 85716

NPI Registry JSON

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

{
    "created_epoch": "1688601600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1762819200000",
    "number": "1639857196",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3438 N COUNTRY CLUB RD",
            "city": "TUCSON",
            "state": "AZ",
            "postal_code": "857161257",
            "telephone_number": "520-286-9964"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3438 N COUNTRY CLUB RD",
            "city": "TUCSON",
            "state": "AZ",
            "postal_code": "857161257",
            "telephone_number": "520-286-9964"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PROJECT RECOVERY OF ARIZONA, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-07-06",
        "last_updated": "2025-11-11",
        "certification_date": "2025-11-11",
        "status": "A",
        "authorized_official_last_name": "JACKSON",
        "authorized_official_first_name": "CHARLES",
        "authorized_official_title_or_position": "CCO",
        "authorized_official_telephone_number": "480-787-1591"
    },
    "taxonomies": [
        {
            "code": "202D00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Integrative Medicine",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "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": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "NOVA VIA TUCSON",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Tucson, AZ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 11, 2025; 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.