| San Tan Adults With Serious Mental Illness Program | |
|
2474 E Hunt Hwy #100 San Tan Valley AZ 85143-5210 | |
| (480) 784-1514 | |
| (480) 967-3528 |
| Full Name | San Tan Adults With Serious Mental Illness Program |
|---|---|
| Speciality | Community/behavioral Health |
| Location | 2474 E Hunt Hwy, San Tan Valley, Arizona |
| Authorized Official Name and Position | Laura Larson-huffaker (EXECUTIVE DIRECTOR) |
| Authorized Official Contact | 4807841514 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| San Tan Adults With Serious Mental Illness Program 618 S Madison Dr Tempe AZ 85281-7248 Ph: (480) 784-1514 | San Tan Adults With Serious Mental Illness Program 2474 E Hunt Hwy #100 San Tan Valley AZ 85143-5210 Ph: (480) 784-1514 |
| NPI Number | 1093259301 |
|---|---|
| Provider Enumeration Date | 12/06/2016 |
| Last Update Date | 06/09/2017 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1093259301 | NPI | - | NPPES |
| 084711 | Medicaid | AZ |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 251S00000X | Community/behavioral Health | OTC7423 (Arizona) | Primary |
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