SOUL SURGERY LLC NPI 1871026674

NPI Information

SOUL SURGERY LLC is a substance abuse rehabilitation facility in Scottsdale, 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. SOUL SURGERY LLC NPI is 1871026674. The provider is registered as an organization entity type and is a multi-specialty group.

The provider's business location address is:

14362 N. FRANK LLOYD WRIGHT
#B111
SCOTTSDALE, AZ
ZIP 85260
Phone: (480) 912-3105
Fax: (480) 912-3106

The provider's authorized official is Regina Shakespeare .
The authorized official title is Billing Compliance Officer and has the following contact phone number (928) 554-5633.

The CLIA number assigned to this NPI record is 03D2129251 - other with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 4/7/2017 and was last updated on 1/31/2020.

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:

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