Provider Demographics
NPI:1730663717
Name:ARIZONA RECOVERY ALLIANCE
Entity type:Organization
Organization Name:ARIZONA RECOVERY ALLIANCE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHEIF CLINICAL OFFICER
Authorized Official - Prefix:MR
Authorized Official - First Name:HAL
Authorized Official - Middle Name:M
Authorized Official - Last Name:NEVITT
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW/LISAC/CEAP
Authorized Official - Phone:602-885-4533
Mailing Address - Street 1:13835 N TATUM BLVD STE 9-178
Mailing Address - Street 2:N/A
Mailing Address - City:PHOENIX
Mailing Address - State:AZ
Mailing Address - Zip Code:85032
Mailing Address - Country:US
Mailing Address - Phone:602-885-4533
Mailing Address - Fax:
Practice Address - Street 1:3040 E. CACTUS RD; #1
Practice Address - Street 2:N/A
Practice Address - City:PHOENIX
Practice Address - State:AZ
Practice Address - Zip Code:85032-0603
Practice Address - Country:US
Practice Address - Phone:602-885-4533
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-09-17
Last Update Date:2018-09-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)Group - Single Specialty