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Organization
SAMARIA BEHAVIORAL HEALTH CENTER LLC
Active
Organization
SAMARIA BEHAVIORAL HEALTH CENTER LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. BENITHO LOUISSAINT NURSE PRACTITIONER (MEMBER)
(480) 471-8980
Entity
Organization
Contact information
Practice address
6197 S RURAL RD, TEMPE, AZ 85283-2909
(480) 471-8980
(480) 912-1061
Mailing address
6197 S RURAL RD, TEMPE, AZ 85283-2909
(480) 471-8980
(480) 912-1061
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
—
NULL
106S00000X
Behavior Technician
—
—
175T00000X
Peer Specialist
—
NULL
175T00000X
Peer Specialist
—
—
251B00000X
Case Management Agency
—
NULL
251S00000X
Community/Behavioral Health Agency
—
NULL
261QM0801X
Mental Health Clinic/Center (Including Community Mental Health Center)
—
NULL
363LF0000X
Family Nurse Practitioner
—
NULL
363LF0000X
Family Nurse Practitioner
—
—
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
—
NULL
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
—
—
367500000X
Certified Registered Nurse Anesthetist
—
NULL
367500000X
Certified Registered Nurse Anesthetist
—
—
Other
Enumeration date
10/05/2020
Last updated
12/13/2024
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