Provider Demographics
NPI:1346659554
Name:REFLECTIONS RECOVERY CENTER, LLC
Entity Type:Organization
Organization Name:REFLECTIONS RECOVERY CENTER, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:FACILTY COORDINATOR
Authorized Official - Prefix:
Authorized Official - First Name:ERIC
Authorized Official - Middle Name:
Authorized Official - Last Name:MARINELLI
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:928-642-3346
Mailing Address - Street 1:957 BLACK DR
Mailing Address - Street 2:SUITE C
Mailing Address - City:PRESCOTT
Mailing Address - State:AZ
Mailing Address - Zip Code:86305-1407
Mailing Address - Country:US
Mailing Address - Phone:928-642-3030
Mailing Address - Fax:928-441-2621
Practice Address - Street 1:957 BLACK DR
Practice Address - Street 2:SUITE C
Practice Address - City:PRESCOTT
Practice Address - State:AZ
Practice Address - Zip Code:86301
Practice Address - Country:US
Practice Address - Phone:928-642-3030
Practice Address - Fax:928-441-2621
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-08-13
Last Update Date:2022-03-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ46880261QR0405X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QR0405XAmbulatory Health Care FacilitiesClinic/CenterRehabilitation, Substance Use Disorder