WOLF CREEK RECOVERY LLC NPI 1699348557

NPI Information

WOLF CREEK 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. WOLF CREEK RECOVERY LLC NPI is 1699348557. The provider is registered as an organization entity type.

The provider's business location address is:

1470 W GURLEY ST
PRESCOTT, AZ
ZIP 86305-855
Phone: (928) 379-4075

The provider's authorized official is Jonathon Phillip Ciampa .
The authorized official title is Ceo and has the following contact phone number (928) 379-4075.

The CLIA number assigned to this NPI record is 03D2240265 - other - beh health with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 7/20/2021 and was last updated on 7/20/2021.

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:

Other Identifiers

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

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.