| Pure Water Recovery And Sober Living, Llc | |
|
15385 W Fillmore St Unit 210 Goodyear AZ 85338-4187 | |
| (248) 212-5615 | |
| Not Available |
| Full Name | Pure Water Recovery And Sober Living, Llc |
|---|---|
| Speciality | Case Management |
| Location | 15385 W Fillmore St Unit 210, Goodyear, Arizona |
| Authorized Official Name and Position | Bridget Miller (OWNER) |
| Authorized Official Contact | 2482125615 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Pure Water Recovery And Sober Living, Llc 15385 W Fillmore St Unit 210 Goodyear AZ 85338-4187 Ph: (248) 212-5615 | Pure Water Recovery And Sober Living, Llc 15385 W Fillmore St Unit 210 Goodyear AZ 85338-4187 Ph: (248) 212-5615 |
| NPI Number | 1720684889 |
|---|---|
| Provider Enumeration Date | 12/04/2020 |
| Last Update Date | 01/18/2022 |
| Certification Date | 01/10/2022 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1720684889 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 251S00000X | Community/behavioral Health | (* (Not Available)) | Secondary |
| 251B00000X | Case Management | (* (Not Available)) | Primary |
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