Provider Demographics
NPI:1659768570
Name:PARTNERS IN RECOVERY, LLC
Entity Type:Organization
Organization Name:PARTNERS IN RECOVERY, LLC
Other - Org Name:PIR MEDICAL ACT FACILITY
Other - Org Type:Other Name
Authorized Official - Title/Position:CBAO
Authorized Official - Prefix:
Authorized Official - First Name:TIFFANY
Authorized Official - Middle Name:R
Authorized Official - Last Name:WOODS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:602-995-6285
Mailing Address - Street 1:924 N COUNTRY CLUB DR
Mailing Address - Street 2:
Mailing Address - City:MESA
Mailing Address - State:AZ
Mailing Address - Zip Code:85201-4108
Mailing Address - Country:US
Mailing Address - Phone:602-258-1112
Mailing Address - Fax:602-252-0866
Practice Address - Street 1:9150 W INDIAN SCHOOL RD
Practice Address - Street 2:BUILING 8
Practice Address - City:PHOENIX
Practice Address - State:AZ
Practice Address - Zip Code:85037-2384
Practice Address - Country:US
Practice Address - Phone:602-239-4100
Practice Address - Fax:602-239-4040
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-04-17
Last Update Date:2015-04-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health