Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Spartan Recovery Life LLC

Organization Addiction (Substance Use Disorder) Psychologist · NPI 1114565553

Spartan Recovery Life LLC is an Addiction (Substance Use Disorder) Psychologist in Prescott, Arizona. Registered with an NPI since 2019.

In the registry since
2019
Specialties on file
2
What do these letters mean?
LLC — Limited liability company
A form of business registration, not a clinical qualification.

See every abbreviation used in this directory →

Practice location Address checks out

919 12th Pl Ste 13
Prescott, AZ 86305-1433
Phone: (833) 228-4222
Fax: (866) 697-2326
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Substance Use Disorder Rehabilitation Clinic/Center (primary) Taxonomy 261QR0405X
Addiction (Substance Use Disorder) Psychologist Taxonomy 103TA0400X

Record details

NPI number1114565553
Entity typeOrganization (Type 2)
Organization subpartNo
Authorized official Debra Kimbro — Director Of Finance · (706) 633-3384
NPI enumeratedDecember 17, 2019
Last updated in NPPESDecember 17, 2019
Certification dateDecember 17, 2019
Mailing address919 12th Pl Ste 13, Prescott, AZ 86305-1433