Provider Demographics
NPI:1487218558
Name:CRISIS PREPARATION AND RECOVERY, INC
Entity Type:Organization
Organization Name:CRISIS PREPARATION AND RECOVERY, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CREDENTIALING MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:GRACIA
Authorized Official - Middle Name:
Authorized Official - Last Name:DANIS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:480-804-0326
Mailing Address - Street 1:1400 E SOUTHERN AVE STE 735
Mailing Address - Street 2:
Mailing Address - City:TEMPE
Mailing Address - State:AZ
Mailing Address - Zip Code:85282-5699
Mailing Address - Country:US
Mailing Address - Phone:480-804-0083
Mailing Address - Fax:480-887-9701
Practice Address - Street 1:9321 W THOMAS RD STE 100
Practice Address - Street 2:
Practice Address - City:PHOENIX
Practice Address - State:AZ
Practice Address - Zip Code:85037-3388
Practice Address - Country:US
Practice Address - Phone:480-804-0326
Practice Address - Fax:480-887-9701
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-04-24
Last Update Date:2019-04-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZ840026Medicaid