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THE POTTER'S HOUSE SUBSTANCE ABUSE CENTER NPI 1225147960


NPI Information

NPI: 1225147960
Provider Name: THE POTTER'S HOUSE SUBSTANCE ABUSE CENTER
Classification: Community/Behavioral Health - 251S00000X
Entity Type: Organization
Address:
1717 W NORTHERN AVE STE 101
PHOENIX, AZ
ZIP 85021
Phone: (602) 254-9701
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THE POTTER'S HOUSE SUBSTANCE ABUSE CENTER is a community behavioral health in Phoenix, AZ. The provider is a private or public agency usually under local government jurisdiction, responsible for assuring the delivery of community based mental health, intellectual disabilities, substance abuse and/or behavioral health services to individuals with those disabilities. Services may range from companion care, respite, transportation, community integration, crisis intervention and stabilization, supported employment, day support, prevocational services, residential support, therapeutic and supportive consultation, environmental modifications, intensive in-home therapy and day treatment, in addition to traditional mental health and behavioral treatment. THE POTTER'S HOUSE SUBSTANCE ABUSE CENTER NPI is 1225147960. The provider is registered as an organization entity type and is a multi-specialty group.

The provider's business location address is:

1717 W NORTHERN AVE STE 101
PHOENIX, AZ
ZIP 85021-400
Phone: (602) 254-9701
Fax: (602) 252-0830

The provider's authorized official is Sheena Rosette Jones .
The authorized official title is Vice President and has the following contact phone number (602) 254-9701.

The enumeration date for this NPI number is 8/29/2006 and was last updated on 10/22/2019.


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 CodeTaxonomy ClasificationTaxonomy SpecializationLicense NumberLicense StatePrimary
1101Y00000XCounselorNo
2251S00000XCommunity/Behavioral HealthBH3520ARIZONANo
3261QR0400XClinic/CenterRehabilitationLISAC-10784ARIZONANo
4251S00000XCommunity/Behavioral HealthYes

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 IdentifierOther Provider Identifier TypeOther Provider Identifier StateOther Provider Identifier Issuer
1004477MEDICAIDARIZONA
21225147960OTHERARIZONANPI

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: 11/14/2023

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