Organization
PRIZM ADDICTION RECOVERY LLC
Active
Organization
PRIZM ADDICTION RECOVERY LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ERIC GLADE MAUGHAN (ADMINSITRATOR)
(602) 292-2010
Entity
Organization
Contact information
Practice address
2734 W BELL RD STE 1385, PHOENIX, AZ 85053-7525
(602) 292-2010
Mailing address
15650 N BLACK CANYON HWY STE 245B, PHOENIX, AZ 85053-4041
(602) 292-2010
Taxonomy
Speciality
Code
Description
License number
State
261QR0400X
Rehabilitation Clinic/Center
—
—
324500000X
Substance Abuse Rehabilitation Facility
Primary
—
—
Other
Enumeration date
12/13/2021
Last updated
09/15/2022
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