Provider Demographics
NPI:1679444269
Name:FOUR PILLARS RECOVERY LLC
Entity type:Organization
Organization Name:FOUR PILLARS RECOVERY LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:STEPHANIE
Authorized Official - Middle Name:
Authorized Official - Last Name:RAY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:928-228-0776
Mailing Address - Street 1:PO BOX 141
Mailing Address - Street 2:
Mailing Address - City:PINETOP
Mailing Address - State:AZ
Mailing Address - Zip Code:85935-0141
Mailing Address - Country:US
Mailing Address - Phone:928-228-0776
Mailing Address - Fax:480-240-9578
Practice Address - Street 1:674 E WHITE MOUNTAIN BLVD
Practice Address - Street 2:SUITE 1
Practice Address - City:PINETOP
Practice Address - State:AZ
Practice Address - Zip Code:85935
Practice Address - Country:US
Practice Address - Phone:928-228-0776
Practice Address - Fax:480-240-9578
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-09-16
Last Update Date:2025-09-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QR0405XAmbulatory Health Care FacilitiesClinic/CenterRehabilitation, Substance Use Disorder