CORE RECOVERY LLC NPI 1073386355

NPI Information

  • NPI: 1073386355
  • Provider Name: CORE RECOVERY LLC
  • Classification: Clinic/Center - 261QR0405X
  • Specialization: Rehabilitation, Substance Use Disorder
  • Entity Type: Organization
  • CLIA Number: 03D2292733
  • Address: 16515 S 40TH ST STE 119B
    PHOENIX, AZ
    ZIP 85048
  • Phone: (602) 810-1210

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NPI Details

CORE RECOVERY LLC is a rehabilitation and substance use disorder clinic center in Phoenix, AZ. CORE RECOVERY LLC NPI is 1073386355. The provider is registered as an organization entity type.

The provider's business location address is:

16515 S 40TH ST STE 119B
PHOENIX, AZ
ZIP 85048-559
Phone: (602) 810-1210
Fax: (480) 247-5625

The provider's authorized official is Jaime Bogovich .
The authorized official title is Operations and has the following contact phone number (518) 698-3757.

The CLIA number assigned to this NPI record is 03D2292733 - other - behavioral health facilit with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 10/30/2023 and was last updated on 4/23/2025.

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
1261QM0850XClinic/CenterAdult Mental HealthNo
2261QR0405XClinic/CenterRehabilitation, Substance Use DisorderYes

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: 3/30/2025

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