SCOTTSDALE PROVIDENCE RECOVERY CENTER - NPI 1740641612

Q: What is Scottsdale Providence Recovery Center's specialty?

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

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About Scottsdale Providence Recovery Center NPPES

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

SCOTTSDALE PROVIDENCE RECOVERY CENTER (NPI 1740641612) is a healthcare organization registered as a rehabilitation, substance use disorder in Scottsdale, Arizona and active in the NPI registry since March 2016. The organization holds a CLIA Waiver certificate valid through May 30, 2028 and lists Daniel Joseph Nichols, Clinical Director, as its authorized official.

NPPES Registry Identity

NPI1740641612

Entity TypeOrganization

Primary Taxonomy261QR0405X

Legal Business NameSCOTTSDALE PROVIDENCE RECOVERY CENTER

Location Address8889 E VIA LINDAScottsdale, AZ 85258-5420

Mailing Address8889 E Via LindaScottsdale, AZ 85258-5420 · (480) 284-7440 · Fax (480) 284-4178

Phone(480) 284-7440

Fax(480) 284-4178

Organization SubpartNo

Authorized OfficialDaniel Joseph NicholsClinical Director · (480) 284-7440

Enumeration DateMarch 18, 2016

Last NPPES UpdateJanuary 23, 20202 updates tracked since enumeration

✔ NPI 1740641612 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 8

★ Primary SpecialtyClinic/Center · Rehabilitation, Substance Use DisorderAmbulatory Health Care Facilities

Taxonomy Code261QR0405X

License✔ Licensed in AZ · BH4837

Also ListedCounselor · Addiction (Substance Use Disorder)Taxonomy 101YA0400X · License BH4837 (AZ)

Also ListedCounselor · Mental HealthTaxonomy 101YM0800X · License BH4837 (AZ)

Also ListedSocial Worker · ClinicalTaxonomy 1041C0700X · License BH4837 (AZ)

Also ListedClinic/Center · Adult Mental HealthTaxonomy 261QM0850X · License BH4837 (AZ)

Also ListedClinic/Center · Multi-SpecialtyTaxonomy 261QM1300X · License BH4837 (AZ)

Also ListedCommunity Based Residential Treatment Facility, Mental IllnessTaxonomy 320800000X · License BH4837 (AZ)

Also ListedSubstance Abuse Rehabilitation FacilityTaxonomy 324500000X · License BH4837 (AZ)

8889 E VIA LINDA, Scottsdale, AZ 85258

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Group Practice 1

Group TaxonomyThis provider is a business group of one or more individual practitioners, who practice with different areas of specialization.193200000X MULTI-SPECIALTY GROUP

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 03D2113737

Scottsdale Providence Recovery Center · Scottsdale, AZ

Active · expires May 30, 2028

CLIA Number03D2113737

Laboratory TypeComp. Outpatient Rehab Facility

Certificate Effective DateMay 31, 2026

Certificate Expiration DateMay 30, 2028

Laboratory DirectorDaniel J. Nichols

Laboratory Phone(480) 284-7440

Laboratory LocationScottsdale Providence Recovery Center8889 E Via Linda Blvd, Scottsdale, AZ 85258

CLIA data matches this NPI record on: Address Name Phone

This certificate is issued to a laboratory to perform only waived tests.

Other Providers at the Same Location NPPES 5

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

CAITLIN BELVIN OTR/L

Occupational Therapist