Phoenix Recovery Clinic LLC

Primary specialty

Intellectual and/or Developmental Disabilities Community Based Residential Treatment FacilityTaxonomy code 320900000X

Legal business name

PHOENIX RECOVERY CLINIC LLC

Doing business as

Phoenix Recovery Center

Practice address

842 S 2ND Ave
Yuma, AZ 85364-3910

Phone

(480) 200-0222

NPI assigned

Sep 27, 2024

Last updated

Sep 27, 2024By 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

Carlos Alberto Munoz Rodriguez

Title

Owner/Administrator

Phone

(480) 200-0222

Specialties & licenses 1

Addresses

Other names 1

• PHOENIX RECOVERY CENTER Doing business as

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

{
    "created_epoch": "1727395200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1727395200000",
    "number": "1790503829",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "842 S 2ND AVE",
            "city": "YUMA",
            "state": "AZ",
            "postal_code": "853643910",
            "telephone_number": "480-200-0222"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "842 S 2ND AVE",
            "city": "YUMA",
            "state": "AZ",
            "postal_code": "853643910",
            "telephone_number": "480-200-0222"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PHOENIX RECOVERY CLINIC LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-09-27",
        "last_updated": "2024-09-27",
        "certification_date": "2024-09-27",
        "status": "A",
        "authorized_official_last_name": "MUNOZ RODRIGUEZ",
        "authorized_official_first_name": "CARLOS",
        "authorized_official_middle_name": "ALBERTO",
        "authorized_official_title_or_position": "OWNER/ADMINISTRATOR",
        "authorized_official_telephone_number": "480-200-0222"
    },
    "taxonomies": [
        {
            "code": "320900000X",
            "taxonomy_group": "",
            "desc": "Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "PHOENIX RECOVERY CENTER",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility in Yuma, AZ
• Providers in Yuma, AZ by specialty
• Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 27, 2024; 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.