PRESCOTT MEDICAL EXECUTIVE DETOX
NPI 1982996989
Substance Abuse Rehabilitation Facility in Prescott, AZ

Q: What is Prescott Medical Executive Detox's NPI number?

The NPI number for Prescott Medical Executive Detox is 1982996989. It was assigned to this organization in the NPPES registry on May 9, 2011.

Q: What is Prescott Medical Executive Detox's specialty?

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

Active since May 09, 2011

134 S GRANITE ST, PRESCOTT, AZ 86303(928) 227-2300(928) 445-1416 Get Directions Write a Review

NPPES record last updated: May 9, 2011. Verified against the NPPES registry weekly; last sync: August 09, 2026.

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About Prescott Medical Executive Detox NPPES

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

PRESCOTT MEDICAL EXECUTIVE DETOX (NPI 1982996989) is a healthcare organization registered as a substance abuse rehabilitation facility in Prescott, Arizona and active in the NPI registry since May 2011. The organization lists Patrick Gallus, Chief Administrator, as its authorized official.

NPPES Registry Identity

NPI1982996989

Entity TypeOrganization

Primary Taxonomy324500000X

Legal Business NamePRESCOTT MEDICAL EXECUTIVE DETOX

Location Address134 S GRANITE STPrescott, AZ 86303-4710

Mailing Address134 S Granite StPrescott, AZ 86303-4710 · (928) 227-2300 · Fax (928) 445-1416

Phone(928) 227-2300

Fax(928) 445-1416

Organization SubpartNo

Authorized OfficialPatrick GallusChief Administrator · (928) 899-0128

Enumeration DateMay 9, 2011

✔ NPI 1982996989 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 · 3273

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.

134 S GRANITE ST, Prescott, AZ 86303

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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 Prescott Medical Executive Detox's NPI number?

The NPI number for Prescott Medical Executive Detox is 1982996989. It was assigned to this organization in the NPPES registry on May 9, 2011.

Where is Prescott Medical Executive Detox located?

Prescott Medical Executive Detox is located at 134 S Granite St, Prescott, AZ 86303. The listed phone number is (928) 227-2300.

What is Prescott Medical Executive Detox's specialty?

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

When was this NPI record last updated?

The NPPES record for Prescott Medical Executive Detox was last updated on May 9, 2011. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 15 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.