| Scottsdale Providence Residential | |
|
9389 E Via Del Sol Dr Scottsdale AZ 85255-5072 | |
| (480) 284-7440 | |
| (480) 284-4178 |
| Full Name | Scottsdale Providence Residential |
|---|---|
| Speciality | Community Based Residential Treatment Facility, Mental Illness |
| Location | 9389 E Via Del Sol Dr, Scottsdale, Arizona |
| Authorized Official Name and Position | Daniel Joseph Nichols (CLINICAL DIRECTOR) |
| Authorized Official Contact | 6024484055 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Scottsdale Providence Residential 8889 E Via Linda Scottsdale AZ 85258-5420 Ph: (480) 284-7440 | Scottsdale Providence Residential 9389 E Via Del Sol Dr Scottsdale AZ 85255-5072 Ph: (480) 284-7440 |
| NPI Number | 1821705104 |
|---|---|
| Provider Enumeration Date | 11/04/2022 |
| Last Update Date | 12/05/2022 |
| Certification Date | 12/05/2022 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1821705104 | NPI | - | NPPES |
| BH8061 | Other | AZ | ADHS LICENSE |
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