Organization
EMPACT - SUICIDE PREVENTION CENTER
Active
Organization
EMPACT - SUICIDE PREVENTION CENTER
Active
Other names
AJ Adult with Serious Mental Illness Program
Organization subpart
No
Provider details
NPI number
Authorized official
LAURA LARSON-HUFFACKER (EXECUTIVE DIRECTOR)
(480) 784-1514
Entity
Organization
Contact information
Practice address
11518 E APACHE TRL, #129, APACHE JUNCTION, AZ 85120-3551
(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
Primary
OTC7842-5DUT11
AZ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
183711
—
AZ
Enumeration date
12/27/2016
Last updated
12/27/2016
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