Provider Demographics
NPI:1013404680
Name:CONTINUUM RECOVERY CENTER
Entity Type:Organization
Organization Name:CONTINUUM RECOVERY CENTER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OFFICE MANAGER
Authorized Official - Prefix:MRS
Authorized Official - First Name:DIANE
Authorized Official - Middle Name:
Authorized Official - Last Name:AYALA-COOK
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:602-466-2036
Mailing Address - Street 1:3710 W GREENWAY RD STE 104
Mailing Address - Street 2:
Mailing Address - City:PHOENIX
Mailing Address - State:AZ
Mailing Address - Zip Code:85053-3729
Mailing Address - Country:US
Mailing Address - Phone:602-466-2036
Mailing Address - Fax:602-993-5648
Practice Address - Street 1:3710 W GREENWAY RD STE 104
Practice Address - Street 2:
Practice Address - City:PHOENIX
Practice Address - State:AZ
Practice Address - Zip Code:85053-3729
Practice Address - Country:US
Practice Address - Phone:602-466-2036
Practice Address - Fax:602-993-5648
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-04-18
Last Update Date:2018-04-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QR0400XAmbulatory Health Care FacilitiesClinic/CenterRehabilitation