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618 S Madison Dr Tempe AZ 85281-7248 | |
| (480) 784-1514 | |
| (480) 967-3528 |
| Full Name | |
|---|---|
| Speciality | Community/behavioral Health |
| Location | 618 S Madison Dr, Tempe, 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 |
|---|---|
618 S Madison Dr Tempe AZ 85281-7248 Ph: (480) 784-1514 | 618 S Madison Dr Tempe AZ 85281-7248 Ph: (480) 784-1514 |
| NPI Number | 1023553211 |
|---|---|
| Provider Enumeration Date | 12/27/2016 |
| Last Update Date | 06/15/2017 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1023553211 | NPI | - | NPPES |
| 756486 | Medicaid | AZ |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 251S00000X | Community/behavioral Health | OTC6752 (Arizona) | Primary |
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Empact-suicide Prevention Center Mental Health Clinic Medicare: Medicare Enrolled Practice Location: 618 S. Madison Drive, Tempe, AZ 85281 Phone: 480-784-1514 Fax: 480-967-3528 | |
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