SOUTHEASTERN ARIZONA BEHAVIORAL HEALTH SVC, INC. (NPI# 1760563704) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1760563704 |
| Entity Type | Organization |
| Organization Name | SOUTHEASTERN ARIZONA BEHAVIORAL HEALTH SVC, INC. |
| Other Organization Name | ADULT THERAPEUTIC FOSTER HOME |
| Practice Address |
1193 Basyl Lane Benson AZ 85602 |
| Mailing Address |
P.o. Box 2161 611 W. Union Street Benson AZ 85602 |
| Practice Telephone | 5202874713 |
| Practice Fax Number | 5202879794 |
| Mailing Telephone | 5205860800 |
| Mailing Fax Number | 5205860116 |
| Enumeration Date | 2006-10-18 |
| Last Update Date | 2010-07-27 |
| Authorized Official Name | MR. JOHN MOTOWSKI (CHIEF FINICIAL OFFICE) |
| Authorized Official Telephone | 5205860800 |
| Authorized Official Credential | M.S. |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 251K00000X | Public Health or Welfare | BH-2810 | AZ | Agencies |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| AZ | AZ DEPT OF HEALTH SERVICE | BH-2810 | 01 |
| Other Name | Type Code |
|---|---|
| Adult Therapeutic Foster Home | Doing Business As Name - Organization |
| Street Address |
1193 BASYL LANE |
| City | BENSON |
| State | AZ |
| Zip Code | 85602 |
| 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 | 251K00000X |
| Grouping | Agencies |
| Classification | Public Health or Welfare |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1346374550 | Countryside Public Health Service | Public Health or Welfare | 201 13th St S, Benson, MN 56215-1856 | 2007-03-16 |
| 1184613788 | Southeastern Arizona Behavioral Health Services, Inc. | Public Health or Welfare | 730-732 W. 4th St., Benson, AZ 85602 | 2005-10-17 |
| 1255329132 | Southeastern Arizona Behavioral Health Services, Inc. | Public Health or Welfare | 590 S Ocotillo Ave, Benson, AZ 85602-6405 | 2005-10-13 |
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| 1699307306 | Arizona Healthcare Outreach | Public Health or Welfare | 3581 W Northern Ave Ste 8, Phoenix, AZ 85051-9404 | 2020-02-10 |
| 1962949008 | Dhew Ind Hlth Sv Hlth Svs & Mntl Hlth Adm | Public Health or Welfare | 1216 N. 307th Avenue, San Lucy Clinic, Gila Bend, AZ 85337 | 2017-01-27 |
| 1316484462 | Golder Ranch Fire District | Public Health or Welfare | 3885 E Golder Ranch Dr, Tucson, AZ 85739-9797 | 2017-01-27 |
| 1609226364 | Clean Colonic LLC | Public Health or Welfare | 7560 S. Willow Dr, Tempe, AZ 85283 | 2016-06-14 |
| 1316304546 | Psa Behavioral Health Agency | Public Health or Welfare | 1308 N Stockton Hill Rd, Suite D, Kingman, AZ 86401-5139 | 2016-01-19 |
| 1346606761 | Banner Whole Health Clinic | Public Health or Welfare | 535 N, Wimont, Tucson, AZ 85711 | 2016-01-14 |
| 1467822734 | Psa Behavioral Health Agency | Public Health or Welfare | 4665 S Ash Ave Ste G-1, Tempe, AZ 85282-6765 | 2015-09-30 |
| 1003207226 | Summit Fire District | Public Health or Welfare | 8905 Koch Field Rd, Flagstaff, AZ 86004-3261 | 2015-02-10 |
| Find all providers with the same taxonomy | ||||
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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.