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SPARTAN RECOVERY LIFE LLC
NPI 1114565553
Clinic/Center - Rehabilitation, Substance Use Disorder in Prescott, AZ

Active since December 17, 2019
919 12TH PL STE 13, PRESCOTT, AZ 86305(833) 228-4222(866) 697-2326 Get Directions Write a Review

NPPES record last updated: December 17, 2019. Verified against the NPPES registry weekly; last sync: July 26, 2026.

About Spartan Recovery Life Llc NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

SPARTAN RECOVERY LIFE LLC (NPI 1114565553) is a healthcare organization registered as a rehabilitation, substance use disorder in Prescott, Arizona and active in the NPI registry since December 2019. The organization lists Debra Kimbro, Director Of Finance, as its authorized official.

NPPES Registry Identity

NPI1114565553
Entity TypeOrganization
Primary Taxonomy261QR0405X
Legal Business NameSPARTAN RECOVERY LIFE LLC
Location Address919 12TH PL STE 13Prescott, AZ 86305-1433
Mailing Address919 12th Pl Ste 13Prescott, AZ 86305-1433
Phone(833) 228-4222
Fax(866) 697-2326
Organization SubpartNo
Authorized OfficialDebra KimbroDirector Of Finance · (706) 633-3384
Enumeration DateDecember 17, 2019
✔ NPI 1114565553 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyClinic/Center · Rehabilitation, Substance Use DisorderAmbulatory Health Care Facilities
Taxonomy Code261QR0405X
Also ListedPsychologist · Addiction (Substance Use Disorder)Taxonomy 103TA0400X
919 12TH PL STE 13, Prescott, AZ 86305
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Group Practice 1

Group TaxonomyThis provdier is a business group of one or more individual practitioners, all of who practice with the same area of specialization.193400000X SINGLE SPECIALTY GROUP

Other Providers at the Same Location NPPES 7

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

DAVID POPE LASAC
Counselor (Addiction (Substance Use Disorder))
919 12TH PL STE 13
PRESCOTT, AZ 86305
Yavapai County (402) 619-6419
RECOVERY IN THE PINES
Community/Behavioral Health
919 12TH PL STE 13
PRESCOTT, AZ 86305
Yavapai County (928) 830-3124
KAREN BLACK RN
Registered Nurse
919 12TH PL STE 13
PRESCOTT, AZ 86305
Yavapai County (928) 227-2967
DANNY DICKERSON LAC
Counselor (Mental Health)
919 12TH PL STE 13
PRESCOTT, AZ 86305
Yavapai County (844) 762-3748
JAMES OWEN THOMAS LISAC
Counselor (Addiction (Substance Use Disorder))
919 12TH PL STE 13
PRESCOTT, AZ 86305
Yavapai County (928) 671-0723
MR. KYLE JACKSON KRESSE LAC
Counselor
919 12TH PL STE 13
PRESCOTT, AZ 86305
Yavapai County (844) 762-3748
WEINRICH HEALTH & WELLNESS
Psychologist (Cognitive & Behavioral)
919 12TH PL STE 13
PRESCOTT, AZ 86305
Yavapai County (928) 533-6805

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Spartan Recovery Life LLC's NPI number?

The NPI number for Spartan Recovery Life LLC is 1114565553. It was assigned to this organization in the NPPES registry on December 17, 2019.

Where is Spartan Recovery Life LLC located?

Spartan Recovery Life LLC is located at 919 12th Pl Ste 13, Prescott, AZ 86305. The listed phone number is (833) 228-4222.

What is Spartan Recovery Life LLC's specialty?

The primary specialty registered for this NPI is Clinic/Center, specializing in Rehabilitation, Substance Use Disorder, with taxonomy code 261QR0405X.

When was this NPI record last updated?

The NPPES record for Spartan Recovery Life LLC was last updated on December 17, 2019. NPI Profile syncs with the weekly NPPES data releases published by CMS.