Provider Demographics
NPI:1285438499
Name:PEER OUTREACH, RECOVERY & REENTRY SERVICES
Entity type:Organization
Organization Name:PEER OUTREACH, RECOVERY & REENTRY SERVICES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MR
Authorized Official - First Name:MANUEL
Authorized Official - Middle Name:THOMAS
Authorized Official - Last Name:ROBINSON
Authorized Official - Suffix:
Authorized Official - Credentials:LCHW,PRSS
Authorized Official - Phone:602-816-1493
Mailing Address - Street 1:11333 N 92ND ST UNIT 2088
Mailing Address - Street 2:
Mailing Address - City:SCOTTSDALE
Mailing Address - State:AZ
Mailing Address - Zip Code:85260-6156
Mailing Address - Country:US
Mailing Address - Phone:602-816-1493
Mailing Address - Fax:
Practice Address - Street 1:423 N COUNTRY CLUB DR STE 34
Practice Address - Street 2:
Practice Address - City:MESA
Practice Address - State:AZ
Practice Address - Zip Code:85201-5725
Practice Address - Country:US
Practice Address - Phone:602-816-1493
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-04-04
Last Update Date:2025-04-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes261QC1500XAmbulatory Health Care FacilitiesClinic/CenterCommunity Health
No1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Multi-Specialty
No251300000XAgenciesLocal Education Agency (LEA)
No251E00000XAgenciesHome Health
No251S00000XAgenciesCommunity/Behavioral Health
No253Z00000XAgenciesIn Home Supportive Care
No302R00000XManaged Care OrganizationsHealth Maintenance Organization