Provider Demographics
NPI:1902607237
Name:HORIZON RECOVERY OUTPATIENT NORTH PHOENIX
Entity type:Organization
Organization Name:HORIZON RECOVERY OUTPATIENT NORTH PHOENIX
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:BRIAN
Authorized Official - Middle Name:
Authorized Official - Last Name:CARLISLE
Authorized Official - Suffix:
Authorized Official - Credentials:FNP-C
Authorized Official - Phone:480-219-7098
Mailing Address - Street 1:6635 W HAPPY VALLEY RD STE A104
Mailing Address - Street 2:
Mailing Address - City:GLENDALE
Mailing Address - State:AZ
Mailing Address - Zip Code:85310-2609
Mailing Address - Country:US
Mailing Address - Phone:623-693-2198
Mailing Address - Fax:
Practice Address - Street 1:18456 N 25TH AVE
Practice Address - Street 2:
Practice Address - City:PHOENIX
Practice Address - State:AZ
Practice Address - Zip Code:85023-1213
Practice Address - Country:US
Practice Address - Phone:480-219-7098
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:HORIZON RECOVERY LLC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2025-03-22
Last Update Date:2025-04-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0855XAmbulatory Health Care FacilitiesClinic/CenterAdolescent and Children Mental Health
No261QR0405XAmbulatory Health Care FacilitiesClinic/CenterRehabilitation, Substance Use Disorder