SOUTHEASTERN ARIZONA BEHAVIORAL HEALTH SERVICES, INC. (NPI# 1407130701) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1407130701 |
| Entity Type | Organization |
| Organization Name | SOUTHEASTERN ARIZONA BEHAVIORAL HEALTH SERVICES, INC. |
| Practice Address |
611 W Union St Benson AZ 85602-6718 |
| Practice Telephone | 5205860800 |
| Practice Fax Number | 5205860116 |
| Enumeration Date | 2011-10-05 |
| Last Update Date | 2011-10-05 |
| Authorized Official Name | JOHN MOTOWSKI (CHIEF FINANCIAL OFFICER) |
| Authorized Official Telephone | 5205860800 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 251S00000X | Community/Behavioral Health | BH3698 | AZ | Agencies |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| AZ | ARIZONA DEPARTMENT OF HEALTH SERVICES - LICENSING | BH3853 | 01 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1467824219 | Southeastern Arizona Behavioral Health Services, Inc. | Community/Behavioral Health | 111 W Blake St, Suite 11, Globe, AZ 85501-2177 | 2015-10-20 |
| 1336421973 | Southeastern Arizona Behavioral Health Services, Inc. | Community/Behavioral Health | 441 N Grand Ave Ste 9, Nogales, AZ 85621-2729 | 2011-09-09 |
| 1316015316 | Southeastern Arizona Behavioral Health Services, Inc. | Public Health or Welfare | 1940 E 11th St, Douglas, AZ 85607-2413 | 2006-11-30 |
| 1932156395 | Southeastern Arizona Behavioral Health Services, Inc. | Public Health or Welfare | 489 N Arroyo Blvd, Nogales, AZ 85621-2644 | 2006-05-30 |
| 1184613788 | Southeastern Arizona Behavioral Health Services, Inc. | Public Health or Welfare | 730-732 W. 4th St., Benson, AZ 85602 | 2005-10-17 |
| 1962490854 | Southeastern Arizona Behavioral Health Services, Inc. | Public Health or Welfare | 1326 Hwy 92, Bisbee, AZ 85603-1151 | 2005-10-13 |
| 1134117047 | Southeastern Arizona Behavioral Health Services, Inc. | Public Health or Welfare | 1615 S 1st Ave, Safford, AZ 85546-2103 | 2005-10-13 |
| 1952399875 | Southeastern Arizona Behavioral Health Services, Inc. | Public Health or Welfare | 185 S Moorman Ave, Sierra Vista, AZ 85635-2700 | 2005-10-13 |
| 1124016019 | Southeastern Arizona Behavioral Health Services, Inc. | Public Health or Welfare | 1701 N Douglas Ave, Douglas, AZ 85607-1019 | 2005-10-13 |
| 1659369569 | Southeastern Arizona Behavioral Health Services, Inc. | Psychiatric Residential Treatment Facility | 470 S Ocotillo Ave, Benson, AZ 85602-6403 | 2005-10-13 |
| Street Address |
611 W UNION ST |
| City | BENSON |
| State | AZ |
| Zip Code | 85602-6718 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1972796266 | Cheryl Henrietta Culen | Nurse Practitioner | 611 W Union St, Benson, AZ 85602-6718 | 2007-08-21 |
| 1124418728 | Tolulope Dada | Nurse Practitioner | 611 W Union St, Benson, AZ 85602-6718 | 2015-02-03 |
| 1780993048 | Daniel Barden | Counselor | 611 W Union St, Benson, AZ 85602-6718 | 2010-10-04 |
| 1396907598 | Sarah Manco | Nurse Practitioner | 611 W Union St, Benson, AZ 85602-6718 | 2008-06-28 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1821582529 | Chiricahua Community Health Centers, Inc | Clinic/Center | 335 South Ocotillo Avenue, Benson, AZ 85602 | 2018-06-18 |
| 1437651288 | Chiricahua Community Health Centers Inc | Pharmacy | 335 S Ocotillo Avenue, Benson, AZ 85602 | 2018-03-07 |
| 1295191641 | Caring Connections for Special Needs, LLC. | Community/Behavioral Health | 870 W 4th St, Benson, AZ 85602 | 2016-01-14 |
| 1396158762 | Nicole Michelle Morris | Audiologist | 1989 S. Frontage Rd., Audiology Hearing and Balance Services, Sierra Vista, AZ 85602 | 2014-06-03 |
| 1467735217 | Josephine Anne Ellsworth | Counselor | 811 Maverick Lane, Benson, AZ 85602 | 2011-09-27 |
| 1730483819 | Charles Dean Kartchner | Anesthesiology | 1357 East Airport Road, Benson, AZ 85602 | 2011-01-04 |
| 1699077321 | Community Bridges, Inc | Clinic/Center | 470 S Ocotillo Ave # 2, Benson, AZ 85602 | 2010-12-01 |
| 1801106844 | Tomas G. Soto | Social Worker | 611 W. Union St., Benson, AZ 85602 | 2010-10-08 |
| 1982929451 | Marla Jeanne Trepanier | Pharmacist | 795 W Fourth Street, Benson, AZ 85602 | 2010-03-29 |
| 1396910832 | Susan May Boge | Occupational Therapist | 1764 N Ocotillo Rd, Benson, AZ 85602 | 2008-04-25 |
| Find all providers in zip 85602 | ||||
| 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 |
|---|---|---|---|---|
| 1295191641 | Caring Connections for Special Needs, LLC. | Community/Behavioral Health | 870 W 4th St, Benson, AZ 85602 | 2016-01-14 |
| 1851712368 | Freedom Counseling LLC | Community/Behavioral Health | 880 W 4th Street, Benson, AZ 85602-9603 | 2013-12-31 |
| 1649502923 | Lazy Horse Ranch | Community/Behavioral Health | 714 N Madison Ave, Benson, AZ 85602-6004 | 2010-02-11 |
| 1346578051 | Swift County Human Services Agency | Community/Behavioral Health | 410 21st Street S, Benson, MN 56215-0208 | 2009-11-19 |
| 1699800979 | Rha Health Services Nc, LLC | Community/Behavioral Health | 501 S Wall St Ste C, Benson, NC 27504-1856 | 2007-02-23 |
| 1760830137 | Southeastern Arizona Behavioral Health Services, Inc. | Community/Behavioral Health | 590 S Ocotillo Ave, Benson, AZ 85602-6405 | 2016-05-26 |
| 1285089961 | Community Provider of Enrichment Services Inc. | Community/Behavioral Health | 324 S Ocotillo Ave, Benson, AZ 85602-6401 | 2016-04-29 |
| 1659658516 | Community Bridges, Inc. | Community/Behavioral Health | 470 S Ocotillo Ave, Benson, AZ 85602-6403 | 2011-11-07 |
| 1588962344 | Caring Connections for Special Needs, LLC | Community/Behavioral Health | 505 E 5th St, Benson, AZ 85602 | 2011-03-03 |
| 1508196809 | It's A New Day Therapy Inc | Community/Behavioral Health | 603 S Wall St, Benson, NC 27504-1823 | 2010-01-08 |
| Find all providers in BENSON | ||||
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| 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.