Provider Demographics
NPI:1275383903
Name:SUSTAINED RECOVERY LLC
Entity Type:Organization
Organization Name:SUSTAINED RECOVERY LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PA-C
Authorized Official - Prefix:
Authorized Official - First Name:AUDREY
Authorized Official - Middle Name:
Authorized Official - Last Name:TOPPING
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:602-345-1233
Mailing Address - Street 1:13802 N SCOTTSDALE RD STE 151-152
Mailing Address - Street 2:
Mailing Address - City:SCOTTSDALE
Mailing Address - State:AZ
Mailing Address - Zip Code:85254-3458
Mailing Address - Country:US
Mailing Address - Phone:602-345-1233
Mailing Address - Fax:
Practice Address - Street 1:6860 E GARY RD
Practice Address - Street 2:
Practice Address - City:SCOTTSDALE
Practice Address - State:AZ
Practice Address - Zip Code:85254-5214
Practice Address - Country:US
Practice Address - Phone:520-223-0785
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-03-25
Last Update Date:2024-03-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedicalGroup - Single Specialty