NPIMap

Organization Active NPI

Southeastern Arizona Behavioral Health Services, Inc.

  • Public Health or Welfare Agency
  • Douglas, AZ
National Provider Identifier
1124016019
Registry record updated Jun 10, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Public Health or Welfare AgencyTaxonomy code 251K00000X
License
BH-1896 Issued in AZ
Legal business name
SOUTHEASTERN ARIZONA BEHAVIORAL HEALTH SERVICES, INC.
Practice address
1701 N Douglas Ave
Douglas, AZ 85607-1019
Phone
(520) 364-1286
Fax
(520) 805-1221
NPI assigned
Oct 13, 2005
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 10, 2022

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

Authorized official

Name
Estella Hernandez, MBA
Title
Contracts & Credentialing Admin
Phone
(520) 838-5513

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Public Health or Welfare Agency 251K00000X BH-1896 AZ Primary

Addresses

Primary practice location

1701 N Douglas Ave
Douglas, AZ 85607-1019

Mailing address

P.O. Box 2161
611 W. Union Street
Benson, AZ 85602
Phone (520) 586-0800

Other names 1

  • SEABHS-Douglas Outpatient Other name

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1129161600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1654819200000",
    "number": "1124016019",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "P.O. BOX 2161",
            "address_2": "611 W. UNION STREET",
            "city": "BENSON",
            "state": "AZ",
            "postal_code": "85602",
            "telephone_number": "520-586-0800",
            "fax_number": "520-586-0116"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1701 N DOUGLAS AVE",
            "city": "DOUGLAS",
            "state": "AZ",
            "postal_code": "856071019",
            "telephone_number": "520-364-1286",
            "fax_number": "520-805-1221"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SOUTHEASTERN ARIZONA BEHAVIORAL HEALTH SERVICES, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-10-13",
        "last_updated": "2022-06-10",
        "certification_date": "2022-06-10",
        "status": "A",
        "authorized_official_last_name": "HERNANDEZ",
        "authorized_official_first_name": "ESTELLA",
        "authorized_official_title_or_position": "CONTRACTS & CREDENTIALING ADMIN",
        "authorized_official_telephone_number": "520-838-5513",
        "authorized_official_credential": "MBA"
    },
    "taxonomies": [
        {
            "code": "251K00000X",
            "taxonomy_group": "",
            "desc": "Public Health or Welfare",
            "state": "AZ",
            "license": "BH-1896",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "SEABHS-Douglas Outpatient",
            "code": "5",
            "type": "Other Name"
        },
        {
            "organization_name": "SEABHS-Douglas Outpatient",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Douglas, AZ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 10, 2022; 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.