NPIMap

Organization Active NPI

Empact - Suicide Prevention Center

  • Community/Behavioral Health Agency
  • Apache Junction, AZ
National Provider Identifier
1114462306
Registry record updated Dec 27, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Behavioral Health AgencyTaxonomy code 251S00000X
License
OTC7842-5DUT11 Issued in AZ
Legal business name
EMPACT - SUICIDE PREVENTION CENTER
Practice address
11518 E Apache TRL
#129
Apache Junction, AZ 85120-3551
Phone
(480) 784-1514
Fax
(480) 967-3528
NPI assigned
Dec 27, 2016
Last updated
Dec 27, 2016By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 27, 2016

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

Authorized official

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Community/Behavioral Health Agency 251S00000X OTC7842-5DUT11 AZ Primary

Addresses

Primary practice location

11518 E Apache TRL
#129
Apache Junction, AZ 85120-3551

Mailing address

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

Other identifiers 1

IdentifierTypeStateIssuer
183711MedicaidAZ

Other names 1

  • AJ Adult 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": "1482796800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1482796800000",
    "number": "1114462306",
    "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": "11518 E APACHE TRL",
            "address_2": "#129",
            "city": "APACHE JUNCTION",
            "state": "AZ",
            "postal_code": "851203551",
            "telephone_number": "480-784-1514",
            "fax_number": "480-967-3528"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EMPACT - SUICIDE PREVENTION CENTER",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-12-27",
        "last_updated": "2016-12-27",
        "status": "A",
        "authorized_official_last_name": "LARSON-HUFFACKER",
        "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": "OTC7842-5DUT11",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "183711",
            "state": "AZ"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "AJ Adult with Serious Mental Illness Program",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Apache Junction, AZ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 27, 2016; 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.