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LOVING HEART RESIDENCES NPI 1952962607


NPI Information

NPI: 1952962607
Provider Name: LOVING HEART RESIDENCES

Doing Business As: PRESTIGE RECOVERY RETREAT

Classification: Substance Abuse Rehabilitation Facility - 324500000X
Entity Type: Organization

CLIA Number: 03D2204223

Address:
11318 N 145TH LN
SURPRISE, AZ
ZIP 85379
Phone: (480) 868-8697
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LOVING HEART RESIDENCES is a substance abuse rehabilitation facility in Surprise, 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. LOVING HEART RESIDENCES NPI is 1952962607. The provider is registered as an organization entity type.
The provider Is Doing Business As Prestige Recovery Retreat.

The provider's business location address is:

11318 N 145TH LN
SURPRISE, AZ
ZIP 85379-353
Phone: (480) 868-8697

The provider's authorized official is Cassandra Fortson .
The authorized official title is Managing Member and has the following contact phone number (480) 868-8697.

The CLIA number assigned to this NPI record is 03D2204223 - assisted living facility with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 6/24/2019 and was last updated on 3/28/2022.


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 CodeTaxonomy ClasificationTaxonomy SpecializationLicense NumberLicense StatePrimary
1310400000XAssisted Living FacilityNo
2323P00000XPsychiatric Residential Treatment FacilityNo
3324500000XSubstance Abuse Rehabilitation FacilityYes

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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