NPIMap

Organization Active NPI

Empact - Suicide Prevention Center

  • Community/Behavioral Health Agency
  • San Tan Valley, AZ
National Provider Identifier
1093259301
Registry record updated Jun 9, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Behavioral Health AgencyTaxonomy code 251S00000X
License
OTC7423 Issued in AZ
Legal business name
EMPACT - SUICIDE PREVENTION CENTER
Practice address
2474 E Hunt Hwy
#100
San Tan Valley, AZ 85143-5210
Phone
(480) 784-1514
Fax
(480) 967-3528
NPI assigned
Dec 6, 2016
Last updated
Jun 9, 2017By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 9, 2017

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Laura Larson-Huffaker
Title
Executive Director
Phone
(480) 784-1514

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Community/Behavioral Health Agency 251S00000X OTC7423 AZ Primary

Addresses

Primary practice location

2474 E Hunt Hwy
#100
San Tan Valley, AZ 85143-5210

Mailing address

618 S Madison Dr
Tempe, AZ 85281-7248
Phone (480) 784-1514

Other identifiers 1

IdentifierTypeStateIssuer
084711MedicaidAZ

Other names 1

  • San Tan Adults with Serious Mental Illness Program Other name

National Provider Directory

National Provider Directory
Tax ID family
Empact Suicide Prevention Center13 organizations share this tax ID, including this one

Other organizations with this tax ID 12

Organizations that report the same tax identification number in the National Provider Directory.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1480982400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1496966400000",
    "number": "1093259301",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "618 S MADISON DR",
            "city": "TEMPE",
            "state": "AZ",
            "postal_code": "852817248",
            "telephone_number": "480-784-1514",
            "fax_number": "480-967-3528"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2474 E HUNT HWY",
            "address_2": "#100",
            "city": "SAN TAN VALLEY",
            "state": "AZ",
            "postal_code": "851435210",
            "telephone_number": "480-784-1514",
            "fax_number": "480-967-3528"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EMPACT - SUICIDE PREVENTION CENTER",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-12-06",
        "last_updated": "2017-06-09",
        "status": "A",
        "authorized_official_last_name": "LARSON-HUFFAKER",
        "authorized_official_first_name": "LAURA",
        "authorized_official_title_or_position": "EXECUTIVE DIRECTOR",
        "authorized_official_telephone_number": "480-784-1514"
    },
    "taxonomies": [
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": "AZ",
            "license": "OTC7423",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "084711",
            "state": "AZ"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "San Tan Adults with Serious Mental Illness Program",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in San Tan Valley, AZ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 9, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.