| Empact-spc | |
|
21476 N John Wayne Pkwy Ste C101 Maricopa AZ 85139-8984 | |
| (520) 316-6068 | |
| (520) 568-6289 |
| Full Name | Empact-spc |
|---|---|
| Speciality | Community/behavioral Health |
| Location | 21476 N John Wayne Pkwy Ste C101, Maricopa, Arizona |
| Authorized Official Name and Position | Brittany Rasmussen (CREDENTIALING COORDINATOR) |
| Authorized Official Contact | 4807841514 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Empact-spc 618 S. Madison Drive Tempe AZ 85281-7248 Ph: (480) 784-1514 | Empact-spc 21476 N John Wayne Pkwy Ste C101 Maricopa AZ 85139-8984 Ph: (520) 316-6068 |
| NPI Number | 1477715803 |
|---|---|
| Provider Enumeration Date | 06/26/2008 |
| Last Update Date | 10/03/2023 |
| Certification Date | 10/03/2023 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1477715803 | NPI | - | NPPES |
| 3046 | Other | AZ | AZ DEPARTMENT OF HEALTH SERVICES BEHAVIORAL HEALTH LICENSE |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 251S00000X | Community/behavioral Health | 3046 (Arizona) | Secondary |
| 251S00000X | Community/behavioral Health | BH-4162 (Arizona) | Primary |
Northern Lights Therapy Pllc Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 21300 N John Wayne Pkwy Ste 103, Maricopa, AZ 85139 Phone: 623-243-2774 | |
Eclipse Psychiatry, Plc Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 21300 N John Wayne Pkwy Ste 103, Maricopa, AZ 85139 Phone: 308-224-4101 | |
Recovery In Motion Llc Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 42080 W Somerset Dr, Maricopa, AZ 85138 Phone: 336-816-0343 Fax: 844-614-6133 | |
Trusted Behavioral Home Care Llc Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 21549 N Backus Dr, Maricopa, AZ 85138 Phone: 480-300-2143 | |
A New Path Treatment Centers Of Florida Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 42080 W Somerset Dr, Maricopa, AZ 85138 Phone: 336-816-0343 | |
La Frontera Empact-spc Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 21476 N John Wayne Pkwy, Suite C101, Maricopa, AZ 85139 Phone: 520-316-6068 | |
Progressive Homecare Services Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 45720 W Tucker Rd, Maricopa, AZ 85139 Phone: 480-773-8480 Fax: 480-546-3626 |