Organization
EMBARK RECOVERY LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DAVID SLATTERY (MANAGER)
(877) 215-2224
Entity
Organization
Contact information
Practice address
1118 WILLOW CREEK RD, PRESCOTT, AZ 86301-1426
(877) 215-2224
(877) 215-2224
Mailing address
PO BOX 12341, GLENDALE, AZ 85318-2341
(877) 215-2224
(877) 215-2224
Taxonomy
Speciality
Code
Description
License number
State
261QR0405X
Substance Use Disorder Rehabilitation Clinic/Center
—
—
324500000X
Substance Abuse Rehabilitation Facility
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
520332
—
AZ
Enumeration date
11/21/2018
Last updated
07/21/2025
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