Organization
RECOVIA LLC ESTRELLA
Active
Other names
Recovia Estrella
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. CINDY PROFFITT C.P.C.,C.P.B., EMT-P (DIRECTOR OF BILLING)
(480) 219-7178
Entity
Organization
Contact information
Practice address
9250 W THOMAS RD STE 250, PHOENIX, AZ 85037-3362
(480) 219-7178
(480) 219-7138
Mailing address
PO BOX 20216, PHOENIX, AZ 85036-0216
(480) 219-7178
(480) 219-8138
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
—
—
101YM0800X
Mental Health Counselor
—
—
103TB0200X
Cognitive & Behavioral Psychologist
—
—
103TC0700X
Clinical Psychologist
—
—
103TP2701X
Group Psychotherapy Psychologist
—
—
163WA0400X
Addiction (Substance Use Disorder) Registered Nurse
—
—
251S00000X
Community/Behavioral Health Agency
—
—
261QM0801X
Mental Health Clinic/Center (Including Community Mental Health Center)
—
—
261QM1300X
Multi-Specialty Clinic/Center
Primary
—
—
320800000X
Mental Illness Community Based Residential Treatment Facility
—
—
324500000X
Substance Abuse Rehabilitation Facility
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1427421098
PROVIDER TYPE 77
—
Enumeration date
06/28/2022
Last updated
10/12/2022
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