NPIMap

Organization Active NPI

Life Transformation Recovery

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Prescott Valley, AZ
National Provider Identifier
1972979862
Registry record updated Oct 27, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health Clinic/Center (Including Community Mental Health Center)Taxonomy code 261QM0801X
License
OTC7200 Issued in AZ
Legal business name
LIFE TRANSFORMATION RECOVERY
Practice address
8521 E Florentine Rd Ste B
Prescott Valley, AZ 86314-8954
Phone
(928) 515-0044
Fax
(928) 433-4977
NPI assigned
Aug 14, 2015
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 27, 2016

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

Authorized official

Name
David Sanchez
Title
Executive Director
Phone
(928) 515-0044

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Clinic/Center (Including Community Mental Health Center) 261QM0801X OTC7200 AZ Primary

Addresses

Primary practice location

8521 E Florentine Rd Ste B
Prescott Valley, AZ 86314-8954

Mailing address

8521 E Florentine Rd Ste B
Prescott Valley, AZ 86314-8954
Phone (928) 515-0044

Other identifiers 1

IdentifierTypeStateIssuer
083523MedicaidAZ

National Provider Directory

National Provider Directory
Tax ID family
Life Transformation Recovery3 organizations share this tax ID, including this one

Other organizations with this tax ID 2

Organizations that report the same tax identification number in the National Provider Directory.

Locations

8521 E Florentine Rd
Ste B
Prescott Valley, AZ 86314
Phone (928) 515-0044

Ownership & related parties

Subparts reporting this organization as parent 2

Organizations that report themselves as subparts in NPPES and name this organization, in the same state, as their parent.

NPI Registry JSON

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

{
    "created_epoch": "1439510400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1477526400000",
    "number": "1972979862",
    "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",
            "fax_number": "928-433-4977"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8521 E FLORENTINE RD STE B",
            "city": "PRESCOTT VALLEY",
            "state": "AZ",
            "postal_code": "863148954",
            "telephone_number": "928-515-0044",
            "fax_number": "928-433-4977"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LIFE TRANSFORMATION RECOVERY",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-08-14",
        "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"
    },
    "taxonomies": [
        {
            "code": "261QM0801X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Mental Health (Including Community Mental Health Center)",
            "state": "AZ",
            "license": "OTC7200",
            "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.

Verify at the official NPI Registry.