SEAGLASS AZ LLC NPI 1003567207

NPI Information

NPI: 1003567207
Provider Name: SEAGLASS AZ LLC

Doing Business As: ROYAL LIFE CENTERS

Classification: Substance Abuse Rehabilitation Facility - 324500000X
Entity Type: Organization
Address:
707 W GURLEY ST
PRESCOTT, AZ
ZIP 86305
Phone: (888) 468-3389
Get Directions

SEAGLASS AZ LLC is a substance abuse rehabilitation facility in Prescott, AZ. The provider is a facility or distinct part of a facility that provides a 24 hr therapeutically planned living and rehabilitative intervention environment for the treatment of individuals with disorders in the abuse of drugs, alcohol, and other substances. SEAGLASS AZ LLC NPI is 1003567207. The provider is registered as an organization entity type.
The provider Is Doing Business As Royal Life Centers.

The provider's business location address is:

707 W GURLEY ST
PRESCOTT, AZ
ZIP 86305-621
Phone: (888) 468-3389

The provider's authorized official is Shandalee Jackson .
The authorized official title is Credentialing Manager and has the following contact phone number (561) 562-6271.

The enumeration date for this NPI number is 1/10/2022 and was last updated on 6/23/2022.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	261QR0405X	Clinic/Center	Rehabilitation, Substance Use Disorder			No
2	324500000X	Substance Abuse Rehabilitation Facility				Yes

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 4/28/2024

NPI Synchronization or Removal

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