Organization · NPI-2

Ac Recovery Center And Wellness LLC

Community/Behavioral Health · Phoenix, AZ

NPI number1285340174

StatusActive

Last updated in NPPESOct 5, 2023

Details

NPI: 1285340174
Entity type: Organization (NPI-2)
Legal business name: Ac Recovery Center And Wellness LLC
Organization subpart: No
Enumeration date: Jan 25, 2023
Certification date: Oct 5, 2023
Last updated: Oct 5, 2023

Taxonomy and licenses

Taxonomy code	Description	License	State	Primary
251S00000X	Community/Behavioral Health	–	–	Yes
103TA0400X	Psychologist, Addiction (Substance Use Disorder)	–	–
101YA0400X	Counselor, Addiction (Substance Use Disorder)	–	–
104100000X	Social Worker	–	–
171M00000X	Case Manager/Care Coordinator	–	–
207KA0200X	Allergy & Immunology, Allergy	–	–
207Q00000X	Family Medicine	–	–
208000000X	Pediatrics	–	–
208VP0014X	Pain Medicine, Interventional Pain Medicine	–	–
363LF0000X	Nurse Practitioner, Family	–	–

Practice location

4216-4218 W Dunlap
Phoenix, AZ 85051

Phone 520-589-9974

Mailing address

4216-4218 W Dunlap
Phoenix, AZ 85051

Phone 520-589-9974

Other practice locations

4228 W Dunlap Ave
Phoenix, AZ 85051-3654

Phone 623-440-1669 · Fax 623-440-3537

Authorized official

Annet Mukamurenzi
Owner
5205899974

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