EMPACT - SUICIDE PREVENTION CENTER


Address: 21476 N John Wayne Pkwy, Suite C101, Maricopa, AZ 85139-8983
Phone: 5203166068

EMPACT - SUICIDE PREVENTION CENTER (NPI# 1073911293) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).

Provider Overview

Nation Provider ID (NPI) 1073911293
Entity Type Organization
Organization Name EMPACT - SUICIDE PREVENTION CENTER
Other Organization Name LA FRONTERA EMPACT-SPC
Practice Address 21476 N John Wayne Pkwy
Suite C101
Maricopa
AZ 85139-8983
Mailing Address 618 S Madison Dr
Tempe
AZ 85281-7248
Practice Telephone 5203166068
Mailing Telephone 4807841514
Mailing Fax Number 4807364939
Enumeration Date 2014-12-22
Last Update Date 2017-06-09
Authorized Official Name LAURA LARSON-HUFFAKER (EXECUTIVE DIRECTOR)
Authorized Official Telephone 4807841514
Authorized Official Credential LPC
Is Organization Subpart N

Taxonomy

Primary Taxonomy Code Classification License Number License State Taxonomy Group
Y 251S00000X Community/Behavioral Health LPC14160 AZ Agencies

Other Provider/Organization Names

Other Name Type Code
La Frontera EMPACT-SPC Doing Business As Name - Organization

Other Provider IDs and Locations

NPI Name Taxonomy Address Enumeration
1164972485 Empact - Suicide Prevention Center Community/Behavioral Health 914 S 52nd St, Tempe, AZ 85281-9500 2016-10-11
1477715803 Empact - Suicide Prevention Center Community/Behavioral Health 21476 N. John Wayne Parkway, Suite # C101, C103, C104, Maricopa, AZ 85139-8983 2008-06-26
1255940649 Empact - Suicide Prevention Center Community Based Residential Treatment Facility, Mental Illness 108 E 2nd Ave, Mesa, AZ 85210-1410 2020-07-30
1194245449 Empact - Suicide Prevention Center Community/Behavioral Health 618 S Madison Dr, Tempe, AZ 85281-7248 2017-06-27
1114462306 Empact - Suicide Prevention Center Community/Behavioral Health 11518 E Apache Trl, #129, Apache Junction, AZ 85120-3551 2016-12-27
1023553211 Empact - Suicide Prevention Center Community/Behavioral Health 618 S Madison Dr, Tempe, AZ 85281-7248 2016-12-27
1437694767 Empact - Suicide Prevention Center Community/Behavioral Health 618 S Madison Dr, Tempe, AZ 85281-7248 2016-12-22
1093259301 Empact - Suicide Prevention Center Community/Behavioral Health 2474 E Hunt Hwy, #100, San Tan Valley, AZ 85143-5210 2016-12-06
1255881579 Empact - Suicide Prevention Center Community/Behavioral Health 11518 E Apache Trl, #129, Apache Junction, AZ 85120-3551 2016-10-11
1831565282 Empact - Suicide Prevention Center Community/Behavioral Health 1035 E Jefferson St, Phoenix, AZ 85034-2295 2015-08-19

Office Location

Street Address 21476 N JOHN WAYNE PKWY
SUITE C101
City MARICOPA
State AZ
Zip Code 85139-8983

Providers in the same location

NPI Name Taxonomy Address Enumeration
1043773096 Erin Wilson Counselor 21476 N John Wayne Pkwy, Maricopa, AZ 85139-8983 2019-04-08
1144751710 Jaclyn Michelle Keller Social Worker 21476 N John Wayne Pkwy, Maricopa, AZ 85139-8983 2017-03-24
1598218968 Mirna Pacheco Counselor 21476 N John Wayne Pkwy, Maricopa, AZ 85139-8983 2016-08-02
1881084952 Amy Coppinger Counselor 21476 N John Wayne Pkwy, Maricopa, AZ 85139-8983 2015-01-28

Providers in the same zip code

NPI Name Taxonomy Address Enumeration
1538778899 Star House Bhrf LLC Clinic/Center 44796 W Sandhill Road, Maricopa, AZ 85139 2020-07-23
1578020988 Dentistry At Maricopa, LLC Dentist 20046 N. John Wayne Pkwy, Ste 105, Maricopa, AZ 85139 2019-02-22
1043732431 The Hands of Grace Case Management 44570 W Sedona Trl, Maricopa, AZ 85139 2017-07-07
1215466636 Dustin Jeremy Sowards Naturopath 18495 N Miller Way, Maricopa, AZ 85139 2017-06-08
1871029090 Carolyn Wanyama Nursing Home Administrator 44880 W Portabello Road, Maricopa, AZ 85139 2017-05-08
1740638758 Melissa Marie Trulson Dentist 44481 W Honeycutt Rd, Suite 109, Maricopa, AZ 85139 2016-05-31
1093189805 Community Partners Integrated Healthcare, Inc. Clinic/Center 20046 N John Wayne Parkway, Ste 102, Maricopa, AZ 85139 2015-11-17
1134523079 Shadale Gillespie Technician 45565 W. Rainbow Dr., Maricopa, AZ 85139 2014-10-21
1578964516 Community Partners Integrated Healthcare, Inc. Clinic/Center 20046 N. John Wayne Parkway, Ste. 106-a, Maricopa, AZ 85139 2014-09-09
1104238716 Jared Kenney Dentist 21300 N John Wayne Pkwy Ste 114, Maricopa, AZ 85139 2014-05-30
Find all providers in zip 85139

Taxonomy Information

Taxonomy Code 251S00000X
Grouping Agencies
Classification Community/Behavioral Health

Taxonomy Definition

A private or public agency usually under local government jurisdiction, responsible for assuring the delivery of community based mental health, mental retardation, substance abuse and/or behavioral health services to individuals with those disabilities. Services may range from companion care, respite, transportation, community integration, crisis intervention and stabilization, supported employment, day support, prevocational services, residential support, therapeutic and supportive consultation, environmental modifications, intensive in-home therapy and day treatment, in addition to traditional mental health and behavioral treatment.
Notes: Source: National Medicaid EDI HIPAA NPI Sub Work Group [1/1/2007: modified definition]

Providers in the same taxonomy and city

NPI Name Taxonomy Address Enumeration
1952938185 Medford's Home, LLC Community/Behavioral Health 44276 W Neely Dr, Maricopa, AZ 85138-9427 2020-03-26
1316583198 Sananga Care Homes LLC Community/Behavioral Health 41996 W Quinto Dr, Maricopa, AZ 85138-2587 2019-11-26
1184186355 Comfort Care Celtic Homes Community/Behavioral Health 22509 N Celtic Ave, Maricopa, AZ 85139-8899 2019-04-04
1427514785 New Haven Treatment Centers of America Community/Behavioral Health 42080 W Somerset Dr, Maricopa, AZ 85138-3277 2019-02-12
1568878239 Frederick Westby Community/Behavioral Health 21300 N John Wayne Pkwy Ste 103, Maricopa, AZ 85139-8964 2014-07-02
1679995260 Pathway To Peace Addiction Recovery and Life Coaching, LLC Community/Behavioral Health 45305 W Horse Mesa Rd, Maricopa, AZ 85139-9128 2014-01-15
1518388289 Before & After Home 4 Boys, LLC Community/Behavioral Health 40408 W Art Pl, Maricopa, AZ 85138-5149 2013-12-26
1629223003 Paul Willis Grover Community/Behavioral Health 40752 W Robbins Dr, Maricopa, AZ 85238-6592 2008-11-26
1477715803 Empact - Suicide Prevention Center Community/Behavioral Health 21476 N. John Wayne Parkway, Suite # C101, C103, C104, Maricopa, AZ 85139-8983 2008-06-26
1629192760 Kathleen Thomsen-grover Community/Behavioral Health 40768 W Robbins Dr, Maricopa, AZ 85238 2007-03-16
Find all providers in MARICOPA

Competitor

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City MARICOPA
Zip Code 85139

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Dataset Information

Data Provider Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES)
Jurisdiction Medicare & Medicaid

This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.

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