Organization
TRAUMA PREVENTION AND RECOVERY LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
TIERRA NATE ABDULLAH (OWNER)
(480) 577-8164
Entity
Organization
Contact information
Practice address
1137 W MCDOWELL RD, PHOENIX, AZ 85007-1747
(480) 577-8164
Mailing address
4504 E WOOD ST, PHOENIX, AZ 85040-9204
(480) 577-8164
Taxonomy
Speciality
Code
Description
License number
State
174200000X
Meals Provider
—
—
251B00000X
Case Management Agency
—
—
261Q00000X
Clinic/Center
—
—
261QC1500X
Community Health Clinic/Center
Primary
—
—
261QM0850X
Adult Mental Health Clinic/Center
—
—
261QM0855X
Adolescent and Children Mental Health Clinic/Center
—
—
261QM1300X
Multi-Specialty Clinic/Center
—
—
261QR0405X
Substance Use Disorder Rehabilitation Clinic/Center
—
—
320800000X
Mental Illness Community Based Residential Treatment Facility
—
—
385H00000X
Respite Care
—
—
Other
Enumeration date
02/03/2022
Last updated
09/27/2024
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