Organization
PARTNERS IN RECOVERY, LLC
Active
Other names
ACT Metro IHH
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
—
OTC5915
ARIZONA DEPARTMENT OF HEALTH LICENSE
AZ
Enumeration date
04/02/2024
Last updated
01/30/2025
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