NPIMap

Organization Active NPI

Southeastern Arizona Behavioral Health Services, Inc.

Doing business as Benson Outpatient Treatment Center

  • Community/Behavioral Health Agency
  • Benson, AZ
National Provider Identifier
1760830137
Registry record updated May 28, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Behavioral Health AgencyTaxonomy code 251S00000X
License
BH4804 Issued in AZ
Legal business name
SOUTHEASTERN ARIZONA BEHAVIORAL HEALTH SERVICES, INC.
Doing business as
Benson Outpatient Treatment Center
Practice address
611 W Union St
Benson, AZ 85602-6718
Phone
(520) 586-6177
NPI assigned
May 26, 2016
Last updated
May 28, 2026By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 28, 2026

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

Authorized official

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Community/Behavioral Health Agency 251S00000X BH4804 AZ Primary

Addresses

Primary practice location

611 W Union St
Benson, AZ 85602-6718

Mailing address

611 W Union St
Benson, AZ 85602-6718

Other names 1

  • Benson Outpatient Treatment Center 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
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.

Locations

590 S Ocotillo St
Benson, AZ 85602
Phone (520) 586-6177

Practitioners & affiliated clinicians

Practitioners 43

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

View all 43

NPI Registry JSON

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

{
    "created_epoch": "1464220800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1779926400000",
    "number": "1760830137",
    "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"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "611 W UNION ST",
            "city": "BENSON",
            "state": "AZ",
            "postal_code": "856026718",
            "telephone_number": "520-586-6177"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SOUTHEASTERN ARIZONA BEHAVIORAL HEALTH SERVICES, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-05-26",
        "last_updated": "2026-05-28",
        "certification_date": "2026-05-28",
        "status": "A",
        "authorized_official_last_name": "WELLS",
        "authorized_official_first_name": "KATHY",
        "authorized_official_middle_name": "GUZMAN",
        "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": "BH4804",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Benson Outpatient Treatment Center",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Benson Outpatient Treatment Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Benson, AZ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 28, 2026; 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.