Organization Active NPI

Heritage Recovery Treatment Center, LLC

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Phoenix, AZ
National Provider Identifier
1972482560
Registry record updated Aug 28, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health Clinic/Center (Including Community Mental Health Center)Taxonomy code 261QM0801X
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, 2025By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 28, 2025

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)CodeLicenseStatePrimary
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 Directory

Locations

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

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.

Verify at the official NPI Registry.