SEAGLASS AZ LLC NPI 1710638226

NPI Information

NPI: 1710638226
Provider Name: SEAGLASS AZ LLC
Classification: Clinic/Center - 261QR0405X
Entity Type: Organization

Specialization: Rehabilitation, Substance Use Disorder

Address:
711 W GURLEY ST
PRESCOTT, AZ
ZIP 86305
Phone: (855) 468-3369
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SEAGLASS AZ LLC is a rehabilitation and substance use disorder clinic center in Prescott, AZ. SEAGLASS AZ LLC NPI is 1710638226. The provider is registered as an organization entity type.

The provider's business location address is:

711 W GURLEY ST
PRESCOTT, AZ
ZIP 86305-621
Phone: (855) 468-3369

The provider's authorized official is Christopher Briney .
The authorized official title is Compliance Manager and has the following contact phone number (805) 512-1694.

The enumeration date for this NPI number is 1/17/2022 and was last updated on 1/17/2022.

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 Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	261QR0405X	Clinic/Center	Rehabilitation, Substance Use Disorder			Yes

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: 11/14/2023

NPI Synchronization or Removal

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