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
—
—
175T00000X
Peer Specialist
—
—
251B00000X
Case Management Agency
—
—
251S00000X
Community/Behavioral Health Agency
—
—
261QM0801X
Mental Health Clinic/Center (Including Community Mental Health Center)
—
—
363LF0000X
Family Nurse Practitioner
—
—
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
—
—
367500000X
Certified Registered Nurse Anesthetist
—
—
Other
Enumeration date
10/05/2020
Last updated
12/13/2024
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