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VOGUE RECOVERY CENTER, LLC
NPI 1417456336
Substance Abuse Rehabilitation Facility in Phoenix, AZ

Active since February 06, 2018CLIA 03D2142747 · Waiver
4122 N 17TH ST, PHOENIX, AZ 85016(818) 916-8116 Get Directions Write a Review

NPPES record last updated: April 16, 2018. Verified against the NPPES registry weekly; last sync: August 09, 2026.

About Vogue Recovery Center, Llc NPPES

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

VOGUE RECOVERY CENTER, LLC (NPI 1417456336) is a healthcare organization registered as a substance abuse rehabilitation facility in Phoenix, Arizona and active in the NPI registry since February 2018. The organization holds a CLIA Waiver certificate valid through January 17, 2028 and lists George Boyadzhyan, Ceo, as its authorized official.

NPPES Registry Identity

NPI1417456336
Entity TypeOrganization
Primary Taxonomy324500000X
Legal Business NameVOGUE RECOVERY CENTER, LLC
Location Address4122 N 17TH STPhoenix, AZ 85016-5922
Mailing Address16501 Sherman Way Ste 100Van Nuys, CA 91406-3757
Phone(818) 916-8116
Organization SubpartNo
Authorized OfficialGeorge BoyadzhyanCeo · (818) 916-8116
Enumeration DateFebruary 6, 2018
Last NPPES UpdateApril 16, 2018
✔ NPI 1417456336 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtySubstance Abuse Rehabilitation FacilityResidential Treatment Facilities
Taxonomy Code324500000X
License✔ Licensed in AZ · BH5357
Definition
A facility or distinct part of a facility that provides a 24 hr therapeutically planned living and rehabilitative intervention environment for the treatment of individuals with disorders in the abuse of drugs, alcohol, and other substances.
4122 N 17TH ST, Phoenix, AZ 85016
Open in Google Maps ↗

Other Identifiers 1

OtherBH5357AZ · Arizona Department Of Health Services

CLIA Laboratory Certificates CMS CLIA

Laboratory certificates issued under the Clinical Laboratory Improvement Amendments (CLIA) program, which sets federal quality standards for human laboratory testing in the United States. There is no official CMS crosswalk between CLIA and NPI numbers; these certificates are associated with this NPI by matching facility names, locations and phone numbers in the CMS CLIA registry.

Certificate of Waiver 03D2142747

Vogue Recovery Center Phoenix · Phoenix, AZ
Active · expires Jan 17, 2028
CLIA Number03D2142747
Laboratory TypeOtc
Certificate Effective DateJanuary 18, 2026
Certificate Expiration DateJanuary 17, 2028
Laboratory DirectorLisa Tomask
Laboratory Phone(602) 265-4663
Laboratory LocationVogue Recovery Center Phoenix4122 N 17th St, Phoenix, AZ 85016
CLIA data matches this NPI record on: Address Name
This certificate is issued to a laboratory to perform only waived tests.

Other Providers at the Same Location NPPES 4

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

KRISTIN JOY HALE LPC
Counselor (Mental Health)
4122 N 17TH ST
PHOENIX, AZ 85016
Maricopa County (602) 239-3704
JAMES MCCREARY LPC
Counselor (Professional)
4122 N 17TH ST
PHOENIX, AZ 85016
Maricopa County (563) 265-7211
KELSEY JONES LPC
Counselor (Professional)
4122 N 17TH ST
PHOENIX, AZ 85016
Maricopa County (602) 293-3704
VOGUE RECOVERY CENTER
Substance Abuse Rehabilitation Facility
4122 N 17TH ST, BUILDING A
PHOENIX, AZ 85016
Maricopa County (818) 304-0705

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 Vogue Recovery Center, LLC's NPI number?

The NPI number for Vogue Recovery Center, LLC is 1417456336. It was assigned to this organization in the NPPES registry on February 6, 2018.

Where is Vogue Recovery Center, LLC located?

Vogue Recovery Center, LLC is located at 4122 N 17th St, Phoenix, AZ 85016. The listed phone number is (818) 916-8116.

What is Vogue Recovery Center, LLC's specialty?

The primary specialty registered for this NPI is Substance Abuse Rehabilitation Facility with taxonomy code 324500000X.

Does Vogue Recovery Center, LLC hold a CLIA laboratory certificate?

Yes. A Certificate of Waiver (number 03D2142747) is associated with this NPI, valid through January 17, 2028. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.

When was this NPI record last updated?

The NPPES record for Vogue Recovery Center, LLC was last updated on April 16, 2018. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 8 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.