EMBARK RECOVERY LLC NPI 1871987495

NPI Information

NPI: 1871987495
Provider Name: EMBARK RECOVERY LLC
Classification: Clinic/Center - 261QR0405X
Entity Type: Organization

Specialization: Rehabilitation, Substance Use Disorder

CLIA Number: 03D2094544

Address:
3727 KARICIO LN
PRESCOTT, AZ
ZIP 86303
Phone: (928) 445-0778
Get Directions

EMBARK RECOVERY LLC is a rehabilitation and substance use disorder clinic center in Prescott, AZ. EMBARK RECOVERY LLC NPI is 1871987495. The provider is registered as an organization entity type.

The provider's business location address is:

3727 KARICIO LN
PRESCOTT, AZ
ZIP 86303-829
Phone: (928) 445-0778
Fax: (928) 445-0780

The provider's authorized official is Taylor H Wood .
The authorized official title is Executive Director and has the following contact phone number (928) 445-0778.

The CLIA number assigned to this NPI record is 03D2094544 - other with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 3/20/2015 and was last updated on 8/18/2021.

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	OTC 7091	ARIZONA	Yes

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
1	520332	MEDICAID	ARIZONA

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

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.

« Previous NPI

Next NPI »