Organization
EMPACT-SUICIDE PREVENTION CENTER
Active
Organization
EMPACT-SUICIDE PREVENTION CENTER
Active
Organization subpart
No
Provider details
NPI number
Authorized official
LIZ MONTANO (CREDENTIALING COORDINATOR)
(480) 784-1514
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 DRIVE, TEMPE, AZ 85281-7248
(480) 784-1514
(480) 967-3528
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
BH 373
AZ
251S00000X
Community/Behavioral Health Agency
Primary
BH-4062
AZ
261QM1300X
Multi-Specialty Clinic/Center
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
971673
—
AZ
Enumeration date
06/19/2007
Last updated
02/23/2021
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