Provider Demographics
NPI:1730315185
Name:RECOVERY CENTERS OF ARIZONA
Entity Type:Organization
Organization Name:RECOVERY CENTERS OF ARIZONA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:VICE PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:DAVID
Authorized Official - Middle Name:
Authorized Official - Last Name:VANDERSCOFF
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:520-572-3744
Mailing Address - Street 1:4917 W DOVE NEST PL
Mailing Address - Street 2:
Mailing Address - City:MARANA
Mailing Address - State:AZ
Mailing Address - Zip Code:85658-4435
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:2717 E GLENN ST
Practice Address - Street 2:
Practice Address - City:TUCSON
Practice Address - State:AZ
Practice Address - Zip Code:85716-2143
Practice Address - Country:US
Practice Address - Phone:520-304-8720
Practice Address - Fax:520-867-6087
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-05-29
Last Update Date:2009-05-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes172V00000XOther Service ProvidersCommunity Health WorkerGroup - Multi-Specialty