Organization · NPI-2

Community Medical Services Arizona-Private, LLC

Clinic/Center, Methadone Clinic · Prescott Valley, AZ

NPI number1457026460

StatusActive

Last updated in NPPESAug 26, 2026

Details

NPI: 1457026460
Entity type: Organization (NPI-2)
Legal business name: Community Medical Services Arizona-Private, LLC
Organization subpart: Yes
Enumeration date: Aug 11, 2021
Certification date: Aug 26, 2026
Last updated: Aug 26, 2026

Taxonomy and licenses

Taxonomy code	Description	License	State	Primary
261QM2800X	Clinic/Center, Methadone Clinic	–	–	Yes
101YA0400X	Counselor, Addiction (Substance Use Disorder)	–	–
251S00000X	Community/Behavioral Health	–	–
261QM0801X	Clinic/Center, Mental Health (Including Community Mental Health Center)	–	–
261QR0405X	Clinic/Center, Rehabilitation, Substance Use Disorder	–	–

Practice location

3155 N. Windsong Drive
Suites A And B
Prescott Valley, AZ 86314-2219

Phone 928-968-7400 · Fax 480-687-7361

Mailing address

8444 N 90th St Ste 100
Scottsdale, AZ 85258-4437

Phone 480-494-2497 · Fax 480-687-7361

Authorized official

Nick Stavros
Ceo
6022488886

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