EMPACT - SUICIDE PREVENTION CENTER (NPI# 1093259301) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1093259301 |
| Entity Type | Organization |
| Organization Name | EMPACT - SUICIDE PREVENTION CENTER |
| Other Organization Name | SAN TAN ADULTS WITH SERIOUS MENTAL ILLNESS PROGRAM |
| Practice Address |
2474 E Hunt Hwy #100 San Tan Valley AZ 85143-5210 |
| Mailing Address |
618 S Madison Dr Tempe AZ 85281-7248 |
| Practice Telephone | 4807841514 |
| Practice Fax Number | 4809673528 |
| Mailing Telephone | 4807841514 |
| Mailing Fax Number | 4809673528 |
| Enumeration Date | 2016-12-06 |
| Last Update Date | 2017-06-09 |
| Authorized Official Name | LAURA LARSON-HUFFAKER (EXECUTIVE DIRECTOR) |
| Authorized Official Telephone | 4807841514 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 251S00000X | Community/Behavioral Health | OTC7423 | AZ | Agencies |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| AZ | 084711 | 05 |
| Other Name | Type Code |
|---|---|
| San Tan Adults with Serious Mental Illness Program | Other Name - Individual/Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1164972485 | Empact - Suicide Prevention Center | Community/Behavioral Health | 914 S 52nd St, Tempe, AZ 85281-9500 | 2016-10-11 |
| 1073911293 | Empact - Suicide Prevention Center | Community/Behavioral Health | 21476 N John Wayne Pkwy, Suite C101, Maricopa, AZ 85139-8983 | 2014-12-22 |
| 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 |
| 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 |
| Street Address |
2474 E HUNT HWY #100 |
| City | SAN TAN VALLEY |
| State | AZ |
| Zip Code | 85143-5210 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1144660671 | Wendy Song | Family Medicine | 2474 E Hunt Hwy, Suite 10, San Tan Valley, AZ 85143-5210 | 2013-06-28 |
| 1659640902 | Banner Primary Care Physicians Arizona LLC | Clinic/Center | 2474 E Hunt Hwy, Suite 10, San Tan Valley, AZ 85143-5210 | 2011-12-15 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1619457785 | Shalom Behavioral Care LLC | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 35301 N Belgian Blue Ct, San Tan Valley, AZ 85143 | 2018-08-18 |
| 1336662337 | House of Dignity Assisted Living LLC | Assisted Living Facility | 214 W Danish Red Trl, San Tan Valley, AZ 85143 | 2017-07-21 |
| 1942744081 | Arizona Dental Professionals, PC | Dentist | 545 E Hunt Hwy, San Tan Valley, AZ 85143 | 2016-12-08 |
| 1285000786 | Jared Scott Snyder | Physical Therapy Assistant | 1745 E Hunt Hwy, Suite 103, San Tan Valley, AZ 85143 | 2015-08-19 |
| 1801289236 | Tiffany Battle | Behavioral Analyst | 2626 E. Manuel Road, San Tan Valley, AZ 85143 | 2015-03-10 |
| 1437541091 | Kelly Denise Griffin | Registered Nurse | 35945 N. Gary Rd, Suite 101, San Tan Valley, AZ 85143 | 2015-02-19 |
| 1528496031 | Casey Manzanedo | Licensed Practical Nurse | 35900 E Charbray Dr., San Tan Valley, AZ 85143 | 2013-10-18 |
| 1891136461 | Lisa Kay Scarpa | Home Health Aide | 925 E Canyon Rock Rd, San Tan Valley, AZ 85143 | 2013-07-11 |
| 1790969426 | Emilia Elizabeth Gomez Vieytez | Pediatrics | 22707 S. Ellsworth Rd H 101, Queen Creek, AZ 85143 | 2007-12-17 |
| 1205814621 | Janet F Rinehart | Family Medicine | 30046 N Varnum Rd, San Tan Valley, AZ 85143 | 2006-01-05 |
| Find all providers in zip 85143 | ||||
| Taxonomy Code | 251S00000X |
| Grouping | Agencies |
| Classification | Community/Behavioral Health |
| 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] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1376159244 | Brothers and Keepers Corporation | Community/Behavioral Health | 3947 W Kirkland Ave, San Tan Valley, AZ 85142-6836 | 2020-09-16 |
| 1114538071 | Springs of Hope Care Services LLC | Community/Behavioral Health | 1224 W Vineyard Plains Dr, San Tan Valley, AZ 85143-3470 | 2020-08-13 |
| 1770103822 | Noble Homes | Community/Behavioral Health | 40353 N Parisi Pl, San Tan Valley, AZ 85140-6825 | 2020-04-19 |
| 1992330104 | Touch Angels Behavioral Health Care LLC | Community/Behavioral Health | 30546 N Edwards Rd, San Tan Valley, AZ 85143-9100 | 2020-03-09 |
| 1962037374 | Living Waters Behavioral Health Services | Community/Behavioral Health | 1036 E Omega Dr, San Tan Valley, AZ 85143-4365 | 2020-03-05 |
| 1720639552 | New Hope Behavioral Residency LLC | Community/Behavioral Health | 424 E Diamond Trl, San Tan Valley, AZ 85143-5872 | 2019-09-23 |
| 1629570379 | Rabiya M. Trotter | Community/Behavioral Health | 41288 N Cambria Dr, San Tan Valley, AZ 85140-3173 | 2018-03-07 |
| 1609376474 | Align Group Home LLC | Community/Behavioral Health | 1460 E Baker Dr, San Tan Valley, AZ 85140-4016 | 2018-02-18 |
| 1801344296 | Grace Mendoza | Community/Behavioral Health | 1180 W Desert Seasons Dr, San Tan Valley, AZ 85143-3438 | 2016-09-14 |
| 1114221272 | Hoofbeats With Heart | Community/Behavioral Health | 43491 N Coyote Rd, San Tan Valley, AZ 85140-8924 | 2011-01-04 |
| Find all providers in SAN TAN VALLEY | ||||
| City | SAN TAN VALLEY |
| Zip Code | 85143 |
Please comment or provide details below to improve the information on EMPACT - SUICIDE PREVENTION CENTER.
| 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.