Provider Demographics
NPI:1467201608
Name:GUIDING ROAD RECOVERY CENTER
Entity type:Organization
Organization Name:GUIDING ROAD RECOVERY CENTER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGING PARTNER
Authorized Official - Prefix:MR
Authorized Official - First Name:MARK
Authorized Official - Middle Name:ANTHONY
Authorized Official - Last Name:NORTH
Authorized Official - Suffix:JR
Authorized Official - Credentials:
Authorized Official - Phone:480-399-8683
Mailing Address - Street 1:11402 N CAVE CREEK RD STE 200
Mailing Address - Street 2:
Mailing Address - City:PHOENIX
Mailing Address - State:AZ
Mailing Address - Zip Code:85020-1410
Mailing Address - Country:US
Mailing Address - Phone:480-399-8683
Mailing Address - Fax:
Practice Address - Street 1:11402 N CAVE CREEK RD
Practice Address - Street 2:
Practice Address - City:PHOENIX
Practice Address - State:AZ
Practice Address - Zip Code:85020-1410
Practice Address - Country:US
Practice Address - Phone:480-399-8683
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-05-17
Last Update Date:2024-05-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QR0405XAmbulatory Health Care FacilitiesClinic/CenterRehabilitation, Substance Use Disorder