Active NPI
Life Transformation Recovery
- Substance Abuse Rehabilitation Facility
- Prescott Valley, AZ
National Provider Identifier
1952758500
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Substance Abuse Rehabilitation Facility
- License
- BH4673
- Legal business name
- LIFE TRANSFORMATION RECOVERY
- Practice address
- 6217 N Reata Dr
Prescott Valley, AZ 86314-3234 - Phone
- (928) 515-0044
- Fax
- (928) 433-4977
- NPI assigned
- May 24, 2016
- Last updated
- Oct 27, 2016
- Organization subpart
- Yes
- Parent organization
- LIFE TRANSFORMATION RECOVERY
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- David Sanchez, RN
- Title
- Executive Director
- Phone
- (928) 515-0044
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Substance Abuse Rehabilitation Facility | 324500000X | BH4673 | AZ | Primary |
Addresses
Primary practice location
6217 N Reata Dr
Prescott Valley, AZ 86314-3234
Mailing address
8521 E Florentine Rd Ste B
Prescott Valley, AZ 86314-8954
Phone (928) 515-0044
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 083523 | Medicaid | AZ |
National Provider Directory
National Provider Directory- Tax ID family
- Life Transformation Recovery
- Part of
- Life Transformation Recovery
Other organizations with this tax ID 2
Organizations that report the same tax identification number in the National Provider Directory.
-
- Mental Health Clinic/Center (Including Community Mental Health Center)
- Prescott Valley, AZ
- NPI 1972979862
-
- Substance Abuse Rehabilitation Facility
- Prescott Valley, AZ
- NPI 1982156691
Ownership & related parties
Parent organization (reported in NPPES) 1
This organization reports itself as a subpart in NPPES; the parent’s legal name matches this organization in the same state.
-
- Mental Health Clinic/Center (Including Community Mental Health Center)
- Prescott Valley, AZ
- NPI 1972979862
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1464048000000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1477526400000",
"number": "1952758500",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "8521 E FLORENTINE RD STE B",
"city": "PRESCOTT VALLEY",
"state": "AZ",
"postal_code": "863148954",
"telephone_number": "928-515-0044"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "6217 N REATA DR",
"city": "PRESCOTT VALLEY",
"state": "AZ",
"postal_code": "863143234",
"telephone_number": "928-515-0044",
"fax_number": "928-433-4977"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "LIFE TRANSFORMATION RECOVERY",
"organizational_subpart": "YES",
"parent_organization_legal_business_name": "LIFE TRANSFORMATION RECOVERY",
"enumeration_date": "2016-05-24",
"last_updated": "2016-10-27",
"status": "A",
"authorized_official_last_name": "SANCHEZ",
"authorized_official_first_name": "DAVID",
"authorized_official_title_or_position": "EXECUTIVE DIRECTOR",
"authorized_official_telephone_number": "928-515-0044",
"authorized_official_credential": "RN"
},
"taxonomies": [
{
"code": "324500000X",
"taxonomy_group": "",
"desc": "Substance Abuse Rehabilitation Facility",
"state": "AZ",
"license": "BH4673",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "083523",
"state": "AZ"
}
],
"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 Oct 27, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.