NPIMap

Organization Active NPI

San Tan Behavioral Health Services

  • Child Mental Illness Respite Care
  • Lakeside, AZ
National Provider Identifier
1962705442
Registry record updated Dec 6, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Child Mental Illness Respite CareTaxonomy code 385HR2055X
License
BH3657 Issued in AZ
Legal business name
SAN TAN BEHAVIORAL HEALTH SERVICES
Practice address
1277 Hummingbird Circle
Lakeside, AZ 85929
Phone
(928) 358-1887
Fax
(480) 632-0026
NPI assigned
Dec 6, 2010
Last updated
Dec 6, 2010By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 6, 2010

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

Authorized official

Name
Melissa Dawn Nelson, M.A., L.P.CNPI 1720489354
Title
Cco
Phone
(480) 734-3851

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Non-emergency Medical Transport (VAN) 343900000X BH3657 AZ
Child Mental Illness Respite Care 385HR2055X BH3657 AZ Primary

Addresses

Primary practice location

1277 Hummingbird Circle
Lakeside, AZ 85929

Mailing address

2451 E Baseline Rd
Gilbert, AZ 85234-2471
Phone (480) 507-3644

National Provider Directory

National Provider Directory
Tax ID family
San Tan Behavioral Health Services LLC7 organizations share this tax ID, including this one

Other organizations with this tax ID 6

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, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1291593600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1291593600000",
    "number": "1962705442",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2451 E BASELINE RD",
            "city": "GILBERT",
            "state": "AZ",
            "postal_code": "852342471",
            "telephone_number": "480-507-3644",
            "fax_number": "480-632-0026"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1277 HUMMINGBIRD CIRCLE",
            "city": "LAKESIDE",
            "state": "AZ",
            "postal_code": "85929",
            "telephone_number": "928-358-1887",
            "fax_number": "480-632-0026"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SAN TAN BEHAVIORAL HEALTH SERVICES",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-12-06",
        "last_updated": "2010-12-06",
        "status": "A",
        "authorized_official_last_name": "NELSON",
        "authorized_official_first_name": "MELISSA",
        "authorized_official_middle_name": "DAWN",
        "authorized_official_title_or_position": "CCO",
        "authorized_official_telephone_number": "480-734-3851",
        "authorized_official_credential": "M.A., L.P.C"
    },
    "taxonomies": [
        {
            "code": "343900000X",
            "taxonomy_group": "",
            "desc": "Non-emergency Medical Transport (VAN)",
            "state": "AZ",
            "license": "BH3657",
            "primary": false
        },
        {
            "code": "385HR2055X",
            "taxonomy_group": "",
            "desc": "Respite Care, Respite Care, Mental Illness, Child",
            "state": "AZ",
            "license": "BH3657",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lakeside, AZ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 6, 2010; 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.