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NORTHSIGHT RECOVERY LLC NPI 1558132704


NPI Information

NPI: 1558132704
Provider Name: NORTHSIGHT RECOVERY LLC
Classification: Community/Behavioral Health - 251S00000X
Entity Type: Organization

CLIA Number: 03D2289209

Address:
605 N GILBERT RD
MESA, AZ
ZIP 85203
Phone: (480) 544-0283
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NORTHSIGHT RECOVERY LLC is a community behavioral health in Mesa, 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. NORTHSIGHT RECOVERY LLC NPI is 1558132704. The provider is registered as an organization entity type.

The provider's business location address is:

605 N GILBERT RD
MESA, AZ
ZIP 85203-629
Phone: (480) 544-0283

The provider's authorized official is Jeremy Vincent Bloom .
The authorized official title is President/ceo and has the following contact phone number (480) 544-0283.

The CLIA number assigned to this NPI record is 03D2289209 - community clinic with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 1/15/2024 and was last updated on 2/22/2024.


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
1261QM0801XClinic/CenterMental Health (Including Community Mental Health Center)No
2261QM0850XClinic/CenterAdult Mental HealthNo
3251B00000XCase ManagementNo
4261QH0100XClinic/CenterHealth ServiceNo
5261QR0405XClinic/CenterRehabilitation, Substance Use DisorderNo
6291U00000XClinical Medical LaboratoryNo
7343900000XNon-emergency Medical Transport (VAN)No
8251S00000XCommunity/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 Identifier Other Provider Identifier Type Other Provider Identifier State Other Provider Identifier Issuer
103D2289209OTHERCLIA
2185032MEDICAIDARIZONA
3OTC13229OTHERARIZONADEPARTMENT OF HEALTH 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: 5/5/2024

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.