SOUTHEASTERN ARIZONA BEHAVORIAL HEALTH SVC, INC. (NPI# 1538251780) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1538251780 |
| Entity Type | Organization |
| Organization Name | SOUTHEASTERN ARIZONA BEHAVORIAL HEALTH SVC, INC. |
| Other Organization Name | CLIFTON OUTPATIENT CLINIC |
| Practice Address |
430 N Coronado Blvd Clifton AZ 85533-8086 |
| Mailing Address |
489 N Arroyo Blvd Nogales AZ 85621-2644 |
| Practice Telephone | 9288654531 |
| Practice Fax Number | 9288654821 |
| Mailing Telephone | 5202874713 |
| Mailing Fax Number | 5202879794 |
| Enumeration Date | 2006-09-28 |
| Last Update Date | 2020-08-22 |
| Authorized Official Name | LAURA E. BETHKE (SR. HR ADMINISTRATOR) |
| Authorized Official Telephone | 5202874713 |
| Authorized Official Credential | BA |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 251K00000X | Public Health or Welfare | BH-2696 | AZ | Agencies |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| AZ | AHCCCS SITE ID | 117888 | 01 |
| Other Name | Type Code |
|---|---|
| Clifton Outpatient Clinic | Doing Business As Name - Organization |
| Street Address |
430 N CORONADO BLVD |
| City | CLIFTON |
| State | AZ |
| Zip Code | 85533-8086 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1033428628 | Karri Rachelle Macri | Social Worker | 430 N Coronado Blvd, Clifton, AZ 85533-8086 | 2010-09-29 |
| 1487728622 | Kathleen A Oldfather | Nurse Practitioner | 430 N Coronado Blvd, Clifton, AZ 85533-8086 | 2006-11-20 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1134568660 | Canyonlands Community Health Care | Clinic/Center | 10 Ward Canyon Road, #a, Clifton, AZ 85533 | 2013-06-18 |
| 1851653125 | Jesse Barrown Hozey | Physician Assistant | 110 Hill St, Clifton, AZ 85533 | 2012-06-13 |
| 1568765899 | Community Partners Integrated Healthcare, Inc. | Community/Behavioral Health | 562 N. Coronado Blvd., Clifton, AZ 85533 | 2010-12-08 |
| 1538389465 | Steven Ralph Owens | Dentist | #1 N. Coronado Blvd., Suite C, Clifton, AZ 85533 | 2007-04-25 |
| 1669540555 | Rudolfo Bruce Campos | Respite Care | 114 Mccormick Canyon, Clifton, AZ 85533 | 2006-12-01 |
| 1336238260 | Barnet Dulaney Perkins Eye Center | Ophthalmology | 264858 Us Highway 198, Clifton, AZ 85533 | 2006-10-11 |
| 1902993470 | Southeastern Arizona Behavioral Health Services | Community/Behavioral Health | 10-a Ward Canyon Road, Room 2, Clifton, AZ 85533 | 2006-10-06 |
| 1730310046 | Greenlee County | Clinic/Center | 253 5th Street, Clifton, AZ 85533-0936 | 2009-08-04 |
| Taxonomy Code | 251K00000X |
| Grouping | Agencies |
| Classification | Public Health or Welfare |
| Definition to come... |
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| 1467822734 | Psa Behavioral Health Agency | Public Health or Welfare | 4665 S Ash Ave Ste G-1, Tempe, AZ 85282-6765 | 2015-09-30 |
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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.