Pure Water Recovery and Sober Living, LLC

Primary specialty

Case Management AgencyTaxonomy code 251B00000X

Legal business name

PURE WATER RECOVERY AND SOBER LIVING, LLC

Practice address

15385 W Fillmore St Unit 210
Goodyear, AZ 85338-4187

Phone

(248) 212-5615

NPI assigned

Dec 4, 2020

Last updated

Jan 18, 2022By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Bridget MillerNPI 1386084861

Title

Owner

Phone

(248) 212-5615

Specialties & licenses 2

Addresses

Locations

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.

• Bridget Miller

  • Social Worker
  • Waterford, MI
  • NPI 1386084861
  NPD Authorized official

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

{
    "created_epoch": "1607040000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1642464000000",
    "number": "1720684889",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "15385 W FILLMORE ST UNIT 210",
            "city": "GOODYEAR",
            "state": "AZ",
            "postal_code": "853384187",
            "telephone_number": "248-212-5615"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "15385 W FILLMORE ST UNIT 210",
            "city": "GOODYEAR",
            "state": "AZ",
            "postal_code": "853384187",
            "telephone_number": "248-212-5615"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PURE WATER RECOVERY AND SOBER LIVING, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-12-04",
        "last_updated": "2022-01-18",
        "certification_date": "2022-01-10",
        "status": "A",
        "authorized_official_last_name": "MILLER",
        "authorized_official_first_name": "BRIDGET",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "248-212-5615"
    },
    "taxonomies": [
        {
            "code": "251B00000X",
            "taxonomy_group": "",
            "desc": "Case Management",
            "state": "NU",
            "license": null,
            "primary": true
        },
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": "NU",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Case Management Agency in Goodyear, AZ
• Providers in Goodyear, AZ by specialty
• Case Management Agency in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 18, 2022; 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.