1962915892 NPI number — CRISIS PREPARATION AND RECOVERY, INC

Table of Contents

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1962915892 NPI number — CRISIS PREPARATION AND RECOVERY, INC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
CRISIS PREPARATION AND RECOVERY, INC
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1962915892
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
11/14/2017
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
1400 E SOUTHERN AVE STE 735
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
TEMPE
Provider Business Mailing Address State Name:
AZ
Provider Business Mailing Address Postal Code:
85282-5699
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
480-804-0326
Provider Business Mailing Address Fax Number:
480-804-0083

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
1828 E FLORENCE BLVD STE 143
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
CASA GRANDE
Provider Business Practice Location Address State Name:
AZ
Provider Business Practice Location Address Postal Code:
85122-4783
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
480-804-0326
Provider Business Practice Location Address Fax Number:
480-804-0083
Provider Enumeration Date:
11/14/2017

Additional Information

Authorized Official

Authorized Official Last Name:
ROBINSON
Authorized Official First Name:
KYLA
Authorized Official Middle Name:
STARR
Authorized Official Title or Position:
CREDENTIALING MANAGER
Authorized Official Telephone Number:
480-804-0326

Provider Taxonomy Codes

  • Taxonomy code: 251S00000X , with the licence number:  OTC-8528 , registered in the state of AZ ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)





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