Core Recovery LLC
Clinic/Center, Rehabilitation, Substance Use Disorder in Phoenix, AZ. Organization (NPI-2).
NPI number1073386355
StatusActive
Last updated in NPPESApr 23, 2025
Details
- NPI
- 1073386355
- Entity type
- Organization (NPI-2)
- Legal business name
- Core Recovery LLC
- Organization subpart
- No
- Enumeration date
- Oct 30, 2023
- Certification date
- Apr 23, 2025
- Last updated
- Apr 23, 2025
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 261QR0405X | Clinic/Center, Rehabilitation, Substance Use Disorder | – | – | Yes |
| 261QM0850X | Clinic/Center, Adult Mental Health | – | – |
Practice location
16515 S 40th St Ste 119bPhoenix, AZ 85048-0559
Phone 602-810-1210 · Fax 480-247-5625
Mailing address
16515 S 40th St Ste 119bPhoenix, AZ 85048-0559
Phone 602-810-1210 · Fax 480-247-5625
Authorized official
Jaime Bogovich
Operations
5186983757
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