Organization
SCOTTSDALE MODERN DETOX LLC
Active
Other names
Scottsdale Detox
Organization subpart
No
Provider details
NPI number
Authorized official
QUINN MCCULLOUGH (CEO)
(480) 466-8754
Entity
Organization
Contact information
Practice address
7283 E EARLL DR BLDG B, SCOTTSDALE, AZ 85251-7230
(480) 549-2220
Mailing address
7904 E CHAPARRAL RD STE A110-473, SCOTTSDALE, AZ 85250-7370
Taxonomy
Speciality
Code
Description
License number
State
261QR0405X
Substance Use Disorder Rehabilitation Clinic/Center
—
—
324500000X
Substance Abuse Rehabilitation Facility
Primary
—
—
Other
Enumeration date
12/23/2022
Last updated
12/28/2022
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