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THE RIVER SOURCE TREATMENT CENTER CASA GRANDE LLC NPI 1851004220


NPI Information

NPI: 1851004220
Provider Name: THE RIVER SOURCE TREATMENT CENTER CASA GRANDE, LLC
Classification: Substance Abuse Rehabilitation Facility - 3245S0500X
Entity Type: Organization

Specialization: Substance Abuse Treatment, Children

Address:
2325 W GUADALUPE RD STE B
GILBERT, AZ
ZIP 85233
Phone: (866) 367-8069
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THE RIVER SOURCE TREATMENT CENTER CASA GRANDE, LLC is a substance abuse treatment and children substance abuse rehabilitation facility in Gilbert, AZ. The provider is a facility or distinct part of a facility for children that provides a 24 hr therapeutically planned living and rehabilitative intervention environment for the treatment of children with disorders in the use of drugs, alcohol, and other substances. Medical and supportive counseling services and education services are included. THE RIVER SOURCE TREATMENT CENTER CASA GRANDE, LLC NPI is 1851004220. The provider is registered as an organization entity type.

The provider's business location address is:

2325 W GUADALUPE RD STE B
GILBERT, AZ
ZIP 85233-811
Phone: (866) 367-8069
Fax: (520) 413-5944

The provider's authorized official is Tina Lee .
The authorized official title is Finance Director and has the following contact phone number (520) 582-4718.

The enumeration date for this NPI number is 1/2/2023 and was last updated on 1/2/2023.


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
13245S0500XSubstance Abuse Rehabilitation FacilitySubstance Abuse Treatment, ChildrenYes

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
1544985MEDICAIDARIZONA

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

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