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PARAMOUNT RECOVERY SERVICES LLC NPI 1578077632


NPI Information

NPI: 1578077632
Provider Name: PARAMOUNT RECOVERY SERVICES, LLC
Classification: Substance Abuse Rehabilitation Facility - 324500000X
Entity Type: Organization

CLIA Number: 03D2119860

Address:
602 BONITA WAY
PRESCOTT, AZ
ZIP 86301
Phone: (928) 583-3409
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PARAMOUNT RECOVERY SERVICES, 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. PARAMOUNT RECOVERY SERVICES, LLC NPI is 1578077632. The provider is registered as an organization entity type.

The provider's business location address is:

602 BONITA WAY
PRESCOTT, AZ
ZIP 86301-002
Phone: (928) 583-3409

The provider's authorized official is Dominique Clark .
The authorized official title is Billing and has the following contact phone number (928) 460-0593.

The CLIA number assigned to this NPI record is 03D2119860 - comp. outpatient rehab facility with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 11/28/2017 and was last updated on 11/28/2017.


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
1324500000XSubstance Abuse Rehabilitation FacilityBL04112ARIZONAYes

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
1BL04112OTHERARIZONASTATE LICENSE

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

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