NPIMap

Organization Active NPI

Southeastern Arizona Behavioral Health Services Inc

  • Community/Behavioral Health Agency
  • Sierra Vista, AZ
National Provider Identifier
1326215955
Registry record updated Aug 12, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Behavioral Health AgencyTaxonomy code 251S00000X
License
BH-3043 Issued in AZ
Legal business name
SOUTHEASTERN ARIZONA BEHAVIORAL HEALTH SERVICES INC
Practice address
4755 Campus Drive
Sierra Vista, AZ 85635
Phone
(520) 458-3932
Fax
(520) 458-3585
NPI assigned
May 13, 2008
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 12, 2025

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

Authorized official

Name
Kathy Wells
Title
Evp/Coo
Phone
(520) 838-5501

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Community/Behavioral Health Agency 251S00000X BH-3043 AZ Primary

Addresses

Primary practice location

4755 Campus Drive
Sierra Vista, AZ 85635

Mailing address

611 W Union St
Benson, AZ 85602-6718
Phone (520) 586-0800

Other identifiers 2

IdentifierTypeStateIssuer
336159MedicaidAZ
OTC-6892OtherAZADHS LICENSING

Other names 1

  • SEABHS Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AZ

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20040421000934 AZ Part B Supplier - Clinic/Group Practice 2860488368 Receives reassigned benefits from 19 practitioners
10 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Sierra Vista, AZ; Willcox, AZ; Safford, AZ; Benson, AZ

Other NPIs on the same Medicare enrollment 6

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

National Provider Directory

National Provider Directory
Tax ID family
Benson Outpatient Treatment Center6 organizations share this tax ID, including this one

Other organizations with this tax ID 5

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

Practitioners & affiliated clinicians

Practitioners 1

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": "1210636800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1754956800000",
    "number": "1326215955",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "611 W UNION ST",
            "city": "BENSON",
            "state": "AZ",
            "postal_code": "856026718",
            "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": "4755 CAMPUS DRIVE",
            "city": "SIERRA VISTA",
            "state": "AZ",
            "postal_code": "85635",
            "telephone_number": "520-458-3932",
            "fax_number": "520-458-3585"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SOUTHEASTERN ARIZONA BEHAVIORAL HEALTH SERVICES INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-05-13",
        "last_updated": "2025-08-12",
        "certification_date": "2025-08-12",
        "status": "A",
        "authorized_official_last_name": "WELLS",
        "authorized_official_first_name": "KATHY",
        "authorized_official_title_or_position": "EVP/COO",
        "authorized_official_telephone_number": "520-838-5501"
    },
    "taxonomies": [
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": "AZ",
            "license": "BH-3043",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "336159",
            "state": "AZ"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ADHS LICENSING",
            "identifier": "OTC-6892",
            "state": "AZ"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "SEABHS",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "SEABHS",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Sierra Vista, AZ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 12, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.