Provider Demographics
NPI:1104282771
Name:ADDICTION RESOURCES, INC.
Entity type:Organization
Organization Name:ADDICTION RESOURCES, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MRS
Authorized Official - First Name:SUSAN
Authorized Official - Middle Name:RICE
Authorized Official - Last Name:SARGENT
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:602-233-9401
Mailing Address - Street 1:4337 W INDIAN SCHOOL RD
Mailing Address - Street 2:107
Mailing Address - City:PHOENIX
Mailing Address - State:AZ
Mailing Address - Zip Code:85031-2982
Mailing Address - Country:US
Mailing Address - Phone:602-233-9401
Mailing Address - Fax:602-233-1302
Practice Address - Street 1:4337 W INDIAN SCHOOL RD
Practice Address - Street 2:107
Practice Address - City:PHOENIX
Practice Address - State:AZ
Practice Address - Zip Code:85031-2982
Practice Address - Country:US
Practice Address - Phone:602-233-9401
Practice Address - Fax:602-233-1302
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-01-12
Last Update Date:2016-01-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZOTC6567261QM2800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM2800XAmbulatory Health Care FacilitiesClinic/CenterMethadone