Lookup NPI Numbers from the NPI Registry
NPI Profile for CANYON REPOSE LLC in PHOENIX, AZ.
Specialty |
Taxonomy Code | Specialty Code | Provider Type | |
Mental Health |
101YM0800X | |||
Addiction (Substance Use Disorder) |
101YA0400X | |||
Addiction Medicine |
207RA0401X | 11 | Physician/Internal Medicine | |
Case Manager/Care Coordinator |
171M00000X | |||
Internal Medicine |
207R00000X | 11 | Physician/Internal Medicine | |
Primary Care |
363LP2300X | 50 | Nurse Practitioner |
| NPI # | 1376420596 |
|
| Status | Active | |
| Credentials | ||
| Entity | Individual | |
| Enumeration date | 08/19/2025 | |
| Last updated | 09/12/2025 - About 9 months ago | |
| Sole proprietor 1 | Not specified | |
| Identifiers | Not Available | |
| Hospital affiliation(s) | Not Available |
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CANYON REPOSE LLC
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CANYON REPOSE LLC