# SAMARIA BEHAVIORAL HEALTH CENTER LLC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1861099798
- **Authorized official:** MR. BENITHO LOUISSAINT NURSE PRACTITIONER (MEMBER)
- **Authorized official phone:** (480) 471-8980

## Contact information

- **Practice address:** 6197 S RURAL RD, TEMPE, AZ 85283-2909
- **Practice address phone:** (480) 471-8980
- **Practice address fax:** (480) 912-1061
- **Mailing address:** 6197 S RURAL RD, TEMPE, AZ 85283-2909
- **Mailing address phone:** (480) 471-8980
- **Mailing address fax:** (480) 912-1061

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 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 | — | NULL | Yes |
| 363LP0808X | Psychiatric/Mental Health Nurse Practitioner | — | — | Yes |
| 367500000X | Certified Registered Nurse Anesthetist | — | NULL | — |
| 367500000X | Certified Registered Nurse Anesthetist | — | — | — |

## Other

- **Enumeration date:** 10/05/2020
- **Last updated:** 12/13/2024