Living Waters Behavioral Health Services

Primary specialty

Community/Behavioral Health AgencyTaxonomy code 251S00000X

Legal business name

LIVING WATERS BEHAVIORAL HEALTH SERVICES

Practice address

5653 E Fox Hollow LN
San Tan Valley, AZ 85140-7635

Phone

(623) 547-1813

NPI assigned

Mar 5, 2020

Organization subpart

No

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

Authorized official

Name

Shunta Dukes

Title

Ceo

Phone

(623) 547-1813

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1583366400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1678752000000",
    "number": "1962037374",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "270 E HUNT HWY, 16-184",
            "city": "SAN TAN VALLEY",
            "state": "AZ",
            "postal_code": "851434365",
            "telephone_number": "480-935-7186"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5653 E FOX HOLLOW LN",
            "city": "SAN TAN VALLEY",
            "state": "AZ",
            "postal_code": "851407635",
            "telephone_number": "623-547-1813"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "466 N 10th Pl",
            "address_purpose": "LOCATION",
            "city": "Coolidge",
            "state": "AZ",
            "postal_code": "851283937",
            "country_code": "US",
            "telephone_number": "623-547-1813",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "LIVING WATERS BEHAVIORAL HEALTH SERVICES",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-03-05",
        "last_updated": "2023-03-14",
        "certification_date": "2023-03-14",
        "status": "A",
        "authorized_official_last_name": "DUKES",
        "authorized_official_first_name": "SHUNTA",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "623-547-1813"
    },
    "taxonomies": [
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Community/Behavioral Health Agency in San Tan Valley, AZ
• Providers in San Tan Valley, AZ by specialty
• Community/Behavioral Health Agency in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 14, 2023; 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.