Empact Suicide Prevention Center Inc | |
4425 W Olive Ave #194 Glendale AZ 85302-3843 | |
(480) 784-1514 | |
(480) 967-3528 |
Full Name | Empact Suicide Prevention Center Inc |
---|---|
Speciality | Community/behavioral Health |
Location | 4425 W Olive Ave, Glendale, Arizona |
Authorized Official Name and Position | Laura Larson-huffaker (EXECUTIVE DIRECTOR) |
Authorized Official Contact | 4807841514 |
Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
Mailing Address | Practice Location Address |
---|---|
Empact Suicide Prevention Center Inc 1232 E Broadway Rd Tempe AZ 85282-1511 Ph: (480) 784-1514 | Empact Suicide Prevention Center Inc 4425 W Olive Ave #194 Glendale AZ 85302-3843 Ph: (480) 784-1514 |
NPI Number | 1659414969 |
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Provider Enumeration Date | 02/15/2007 |
Last Update Date | 07/28/2010 |
Identifier | Type | State | Issuer |
---|---|---|---|
1659414969 | NPI | - | NPPES |
622987 | Medicaid | AZ |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
251S00000X | Community/behavioral Health | BH-1958 (Arizona) | Primary |
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