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SCOTTSDALE PROVIDENCE RESIDENTIAL
NPI 1821705104
Community Based Residential Treatment Facility, Mental Illness in Scottsdale, AZ

Active since November 04, 2022CLIA 03D2273743 · Waiver
9389 E VIA DEL SOL DR, SCOTTSDALE, AZ 85255(480) 284-7440(480) 284-4178 Get Directions Write a Review

NPPES record last updated: December 5, 2022. Verified against the NPPES registry weekly; last sync: August 02, 2026.

Record update history: Dec 5, 2022, Nov 7, 2022, Nov 4, 2022 (3 updates tracked since 2022).

About Scottsdale Providence Residential NPPES

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

SCOTTSDALE PROVIDENCE RESIDENTIAL (NPI 1821705104), doing business as Scottsdale Providence Residential Center, is a healthcare organization registered as a community based residential treatment facility, mental illness in Scottsdale, Arizona and active in the NPI registry since November 2022. The organization holds a CLIA Waiver certificate valid through December 18, 2026 and lists Daniel Joseph Nichols, Clinical Director, as its authorized official.

NPPES Registry Identity

NPI1821705104
Entity TypeOrganization
Primary Taxonomy320800000X
Legal Business NameSCOTTSDALE PROVIDENCE RECOVERY CENTER
Location Address9389 E VIA DEL SOL DRScottsdale, AZ 85255-5072
Mailing Address8889 E Via LindaScottsdale, AZ 85258-5420 · (480) 284-7440 · Fax (480) 284-4178
Phone(480) 284-7440
Fax(480) 284-4178
Organization SubpartYes
Authorized OfficialDaniel Joseph NicholsClinical Director · (602) 448-4055
Enumeration DateNovember 4, 2022
Last NPPES UpdateDecember 5, 20223 updates tracked since enumeration
NPPES CertifiedDecember 5, 2022
✔ NPI 1821705104 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 6

★ Primary SpecialtyCommunity Based Residential Treatment Facility, Mental IllnessResidential Treatment Facilities
Taxonomy Code320800000X
Definition
A home-like residential facility providing psychiatric treatment and psycho/social rehabilitative services to individuals diagnosed with mental illness.
Also ListedCounselor · Mental HealthTaxonomy 101YM0800X
Also ListedClinic/Center · Adult Mental HealthTaxonomy 261QM0850X
Also ListedClinic/Center · Multi-SpecialtyTaxonomy 261QM1300X
Also ListedClinic/Center · Rehabilitation, Substance Use DisorderTaxonomy 261QR0405X
Also ListedSubstance Abuse Rehabilitation FacilityTaxonomy 324500000X
9389 E VIA DEL SOL DR, Scottsdale, AZ 85255
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Other Names 2

Other NameScottsdale Providence Residential
Doing Business AsScottsdale Providence Residential Center

Other Identifiers 1

OtherBH8061AZ · Adhs License

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 03D2273743

Scottsdale Providence Recovery Center · Scottsdale, AZ
Active · expires Dec 18, 2026
CLIA Number03D2273743
Laboratory TypeResidential Treatment
Certificate Effective DateDecember 19, 2024
Certificate Expiration DateDecember 18, 2026
Laboratory DirectorDaniel J. Nichols
Laboratory Phone(480) 284-4178
Laboratory LocationScottsdale Providence Recovery Center9389 E Via Del Sol Dr, Scottsdale, AZ 85255
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

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

ANDREW DAVID PARKER LMSW
Social Worker (Clinical)
9389 E VIA DEL SOL DR
SCOTTSDALE, AZ 85255
Maricopa County (480) 590-4606

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 Scottsdale Providence Recovery Center's NPI number?

The NPI number for Scottsdale Providence Recovery Center is 1821705104. It was assigned to this organization in the NPPES registry on November 4, 2022. The provider is doing business as Scottsdale Providence Residential Center. The provider is also known as Scottsdale Providence Residential.

Where is Scottsdale Providence Recovery Center located?

Scottsdale Providence Recovery Center is located at 9389 E Via Del Sol Dr, Scottsdale, AZ 85255. The listed phone number is (480) 284-7440.

What is Scottsdale Providence Recovery Center's specialty?

The primary specialty registered for this NPI is Community Based Residential Treatment Facility, Mental Illness with taxonomy code 320800000X.

Does Scottsdale Providence Recovery Center hold a CLIA laboratory certificate?

Yes. A Certificate of Waiver (number 03D2273743) is associated with this NPI, valid through December 18, 2026. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.

When was this NPI record last updated?

The NPPES record for Scottsdale Providence Recovery Center was last updated on December 5, 2022. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 3 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.