Active NPI
Heritage Recovery Treatment Center, LLC
- Mental Health Clinic/Center (Including Community Mental Health Center)
- Phoenix, AZ
National Provider Identifier
1972482560
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Mental Health Clinic/Center (Including Community Mental Health Center)
- Legal business name
- HERITAGE RECOVERY TREATMENT CENTER, LLC
- Practice address
- 1717 W Northern Ave Ste 200B
Phoenix, AZ 85021-5469 - Phone
- (747) 463-9226
- NPI assigned
- Aug 28, 2025
- Last updated
- Aug 28, 2025
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Norrice Tindimubona
- Title
- Owner
- Phone
- (747) 463-9226
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Mental Health Clinic/Center (Including Community Mental Health Center) | 261QM0801X | NU | Primary |
Addresses
Primary practice location
1717 W Northern Ave Ste 200B
Phoenix, AZ 85021-5469
Mailing address
1717 W Northern Ave Ste 200B
Phoenix, AZ 85021-5469
Phone (747) 463-9226
National Provider Directory
National Provider DirectoryLocations
1717 W Northern Ave
Ste 200B
Phoenix, AZ 85021
Phone (602) 895-5887
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1756339200000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1756339200000",
"number": "1972482560",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1717 W NORTHERN AVE STE 200B",
"city": "PHOENIX",
"state": "AZ",
"postal_code": "850215469",
"telephone_number": "747-463-9226"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1717 W NORTHERN AVE STE 200B",
"city": "PHOENIX",
"state": "AZ",
"postal_code": "850215469",
"telephone_number": "747-463-9226"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "HERITAGE RECOVERY TREATMENT CENTER, LLC",
"organizational_subpart": "NO",
"enumeration_date": "2025-08-28",
"last_updated": "2025-08-28",
"certification_date": "2025-08-28",
"status": "A",
"authorized_official_last_name": "TINDIMUBONA",
"authorized_official_first_name": "NORRICE",
"authorized_official_title_or_position": "OWNER",
"authorized_official_telephone_number": "747-463-9226"
},
"taxonomies": [
{
"code": "261QM0801X",
"taxonomy_group": "",
"desc": "Clinic/Center, Mental Health (Including Community Mental Health Center)",
"state": "NU",
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Phoenix, AZ
- Here4U Transport LLC
- Desiree Monique Heredia
- Heritage Behavioral Center, LLC (Heritage Living Center)
- Heritage Home Healthcare of Arizona, Inc
- Heritage House Behavioral Health Services
- Cienna Herlihy
- Erin Christine Herling, MS, CCC-SLP
- Bruce C Herman, M.D.
- David Benjamin Herman, D.C.
- Diana M Herman, M.D,
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 28, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.