Provider Demographics
NPI:1437525797
Name:ADDICTION RECOVERY CENTERS, LLC
Entity Type:Organization
Organization Name:ADDICTION RECOVERY CENTERS, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANGER
Authorized Official - Prefix:DR
Authorized Official - First Name:JAMES
Authorized Official - Middle Name:
Authorized Official - Last Name:SIEFFERT
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:480-331-4540
Mailing Address - Street 1:425 E 11TH AVE
Mailing Address - Street 2:
Mailing Address - City:MESA
Mailing Address - State:AZ
Mailing Address - Zip Code:85204-4905
Mailing Address - Country:US
Mailing Address - Phone:480-205-9447
Mailing Address - Fax:
Practice Address - Street 1:3724 N 3RD ST
Practice Address - Street 2:STE 201
Practice Address - City:PHOENIX
Practice Address - State:AZ
Practice Address - Zip Code:85012-2034
Practice Address - Country:US
Practice Address - Phone:480-331-4540
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-08-20
Last Update Date:2017-05-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2084A0401XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyAddiction MedicineGroup - Multi-Specialty
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)Group - Multi-Specialty
No207LA0401XAllopathic & Osteopathic PhysiciansAnesthesiologyAddiction MedicineGroup - Multi-Specialty
No207QA0401XAllopathic & Osteopathic PhysiciansFamily MedicineAddiction MedicineGroup - Multi-Specialty
No261QM0801XAmbulatory Health Care FacilitiesClinic/CenterMental Health (Including Community Mental Health Center)Group - Multi-Specialty