Re-Creation Retreat LLC
NPI 1629339437 · Mental Illness Community Based Residential Treatment Facility · Fredonia, AZ
Re-Creation Retreat LLC is a Mental Illness Community Based Residential Treatment Facility organization in Fredonia, AZ (NPI 1629339437).
Provider details
- NPI number
- 1629339437
- Entity type
- Organization
- Primary specialty
- Mental Illness Community Based Residential Treatment FacilityResidential Treatment Facilities
- Organization subpart
- No
- Authorized official
- Randy Soderquist, Owner and Clinical Director(435) 691-0856
- License
- BH-3895 (AZ)
Specialties & taxonomies
Residential Treatment Facilities
Residential Treatment Facilities
Profile Score
A profile completeness & documented-activity index — NOT a quality, outcomes, or patient-satisfaction rating.
- Registry tenure38% of score
14 yrs in NPPES registry
- Profile completeness38% of score
100% of core fields populated
- Practice footprint23% of score
1 documented practice location
Signals a provider has no public data for (e.g. Medicare claims) are left out of the score entirely — never counted as zero — so providers without that data are not penalized. See the full formula and weights in our methodology.
Practice location
Mailing address
Registry dates
- Enumerated
- 2012-06-07
- Last updated
- 2012-11-21
Frequently asked questions
- What is Re-Creation Retreat LLC's NPI number?
- Re-Creation Retreat LLC's National Provider Identifier (NPI) is 1629339437, a unique 10-digit ID issued by CMS for use in standard healthcare transactions.
- What type of organization is Re-Creation Retreat LLC?
- Re-Creation Retreat LLC is classified in the NPPES registry as Mental Illness Community Based Residential Treatment Facility (Residential Treatment Facilities).
- Where is Re-Creation Retreat LLC located?
- Re-Creation Retreat LLC's practice location on file with NPPES is 455 South Main, Fredonia, AZ 86022.
- What is Re-Creation Retreat LLC's phone number?
- The practice phone number listed in the NPPES registry for Re-Creation Retreat LLC is (435) 691-0856.
- Who is the authorized official for Re-Creation Retreat LLC?
- The authorized official listed on Re-Creation Retreat LLC's NPPES record is Randy Soderquist, Owner and Clinical Director. The authorized official registers and maintains the organization's NPI and is not necessarily its owner.
- Is Re-Creation Retreat LLC's NPI active?
- Yes — Re-Creation Retreat LLC's NPI (1629339437) is active in the NPPES registry as of the last update on 2012-11-21.
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.