Provider Demographics
NPI:1770718546
Name:RECOVERY INNOVATIONS OF ARIZONA, INC
Entity type:Organization
Organization Name:RECOVERY INNOVATIONS OF ARIZONA, INC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MS
Authorized Official - First Name:CHRISTY
Authorized Official - Middle Name:
Authorized Official - Last Name:DYE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:602-650-1212
Mailing Address - Street 1:2701 N 16TH ST
Mailing Address - Street 2:SUITE 316
Mailing Address - City:PHOENIX
Mailing Address - State:AZ
Mailing Address - Zip Code:85006-1263
Mailing Address - Country:US
Mailing Address - Phone:602-650-1212
Mailing Address - Fax:602-636-5211
Practice Address - Street 1:365 S MAIN ST
Practice Address - Street 2:
Practice Address - City:CAMP VERDE
Practice Address - State:AZ
Practice Address - Zip Code:86322-7272
Practice Address - Country:US
Practice Address - Phone:928-567-3834
Practice Address - Fax:928-567-8711
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:RECOVERY INNOVATIONS OF ARIZONA, INC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2009-05-22
Last Update Date:2009-05-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZBH-3261251S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health