Organization
PARTNERS IN RECOVERY, LLC
Active
Organization
PARTNERS IN RECOVERY, LLC
Active
Other names
Partners In Recovery Metro Center Integrated Care Clinic
Organization subpart
No
Provider details
NPI number
Authorized official
LATRICE SHANNON HICKMAN (CHIEF RISK AND COMPLIANCE OFFICER)
(480) 431-9008
Entity
Organization
Contact information
Practice address
10217 N METRO PKWY W, PHOENIX, AZ 85051-1438
(602) 997-9006
(602) 997-4585
Mailing address
924 N COUNTRY CLUB DR, MESA, AZ 85201-4108
(480) 969-3800
Taxonomy
Speciality
Code
Description
License number
State
261Q00000X
Clinic/Center
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
OTC13278
ARIZONA DEPARTMENT OF HEALTH SERVICES - LICENSING
AZ
Enumeration date
04/03/2024
Last updated
08/14/2024
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