SOUL SURGERY LLC – NPI #1871026674
Substance Abuse Rehabilitation Facility

A facility or distinct part of a facility that provides a 24 hr therapeutically planned living and rehabilitative intervention environment for the treatment of individuals with disorders in the abuse of drugs, alcohol, and other substances.

Health Care Provider Taxonomy Code for Substance Abuse Rehabilitation Facility

SOUL SURGERY LLC is a substance abuse rehabilitation facility located in SCOTTSDALE, AZ. NPPES has assigned the NPI number 1871026674 to SOUL SURGERY LLC on April 07, 2017. It is a Type-2 NPI, indicating this NPI number is associated with an organization. With multiple taxonomy codes selected, the primary taxonomy selected by this provider is 324500000X from the Health Care Provider Taxonomy code set, which is classified as Substance Abuse Rehabilitation Facility.

The NPI profile was previously updated about 6 years ago on Jan 31, 2020. Use the NPI data found here to bill health insurance companies, identify providers enrolled in Medicare and Medicaid services or other HIPAA compliant transactions. See the complete NPI profile for SOUL SURGERY LLC below.

NPI Profile for
SOUL SURGERY LLC

NPI Number
1871026674
Enumeration Date

(more than 9 years ago)
Entity Type
Type-2  Organization
Organization health care providers may have a single employee or thousands of employees. An example is an incorporated individual who is an organization's only employee.
Legal Name
SOUL SURGERY LLC
Primary location
14362 N. FRANK LLOYD WRIGHT
#B111
SCOTTSDALE, AZ 85260
Phone: (480) 912-3105 Fax: (480) 912-3106
Mailing address
Same as primary location
Organization Subpart
No
Authorized Official
REGINA SHAKESPEARE
BILLING COMPLIANCE OFFICER
Phone: (928) 554-5633
Updated
Certification Date
Jan 31, 2020

Note: NPPES allows providers to attest to the accuracy of their NPI data. When a provider request any change to the NPI record, they will be able to attest to their changed NPI data, resulting in an updated certification date.

Taxonomy Code(s)

A taxonomy code is a code that describes the health care service provider's type, classification, and the area of specialization. The primary specialty for this provider is indicated as (Primary) below.

Taxonomy Classification / Specialization State License
324500000X
- Substance Abuse Rehabilitation Facility (Primary)
364SP0809X
- Clinical Nurse Specialist / Psychiatric/Mental Health, Adult		 AZ OTC7755
251S00000X
- Community/Behavioral Health		 AZ OTC8541
101YA0400X
- Counselor / Addiction (Substance Use Disorder)		 AZ OTC7755

The taxonomy codes are selected by the provider at the time of NPI registration. Selection of a taxonomy code does not replace any credentialing or validation process that the provider requesting the code should complete.