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EMBARK RECOVERY LLC NPI 1184193963


NPI Information

NPI: 1184193963
Provider Name: EMBARK RECOVERY LLC
Classification: Substance Abuse Rehabilitation Facility - 324500000X
Entity Type: Organization

CLIA Number: 03D2159160

Address:
3727 KARICIO LN
PRESCOTT, AZ
ZIP 86303
Phone: (877) 215-2224
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EMBARK RECOVERY 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. EMBARK RECOVERY LLC NPI is 1184193963. The provider is registered as an organization entity type.

The provider's business location address is:

3727 KARICIO LN
PRESCOTT, AZ
ZIP 86303-829
Phone: (877) 215-2224
Fax: (877) 215-2224

The provider's authorized official is David Slattery .
The authorized official title is Manager and has the following contact phone number (877) 215-2224.

The CLIA number assigned to this NPI record is 03D2159160 - comp. outpatient rehab facility with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 11/21/2018 and was last updated on 1/18/2024.


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
1261QR0405XClinic/CenterRehabilitation, Substance Use DisorderNo
2324500000XSubstance Abuse Rehabilitation FacilityYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No. Other Provider Identifier Other Provider Identifier Type Other Provider Identifier State Other Provider Identifier Issuer
1520332MEDICAIDARIZONA

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: 5/5/2024

All materials and services on this site are provided on an "as is" and "as available" basis without warranty of any kind. The NPI record is maintained by the National Plan & Provider Enumeration System (NPPES) and anyone may request this information and other NPPES health care provider data from HHS under The Freedom of Information Act (FOIA), Title 5 of the United States Code, section 552. To update the NPI records please contact the NPPES.