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Organization

EMPACT-SUICIDE PREVENTION CENTER

Active
Organization subpart
No

Provider details

NPI number
Authorized official
JENNIFER HOUDE (CREDENTIALING)
(928) 642-5583
Entity
Organization

Contact information

Practice address
618 S. MADISON DRIVE, TEMPE, AZ 85281-7248
(480) 784-1514
(480) 967-3528
Mailing address
618 S MADISON DR, TEMPE, AZ 85281-7248
(480) 784-1514
(480) 967-3528

Taxonomy

Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
BH 1958
AZ
251S00000X
Community/Behavioral Health Agency
BH-373
AZ
251S00000X
Community/Behavioral Health Agency
Primary
BH-4062
AZ

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
100587
AZ
05
622987
AZ
Enumeration date
11/28/2006
Last updated
01/20/2026
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