PSA BEHAVIORAL HEALTH AGENCY (NPI# 1366864423) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1366864423 |
| Entity Type | Organization |
| Organization Name | PSA BEHAVIORAL HEALTH AGENCY |
| Practice Address |
1500 E 15th St Room 608 Douglas AZ 85607-1731 |
| Mailing Address |
2255 W Northern Ave Suite B100 Phoenix AZ 85021-4936 |
| Practice Telephone | 6029951767 |
| Mailing Telephone | 6029951767 |
| Mailing Fax Number | 6024431005 |
| Enumeration Date | 2014-01-09 |
| Last Update Date | 2014-01-09 |
| Authorized Official Name | KIMBERLY QUIROS (DIRECTOR OF I.T. & CLAIMS) |
| Authorized Official Telephone | 6029951767 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 251K00000X | Public Health or Welfare | OTC6116 | AZ | Agencies |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| AZ | AHCCCS ID | 000000 | 01 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1366094930 | Psa Behavioral Health Agency | Community/Behavioral Health | 3271 E. Queen Creek Road, Ste. 105, 110, 111, Gilbert, AZ 85297 | 2019-07-12 |
| 1255891065 | Psa Behavioral Health Agency | Community/Behavioral Health | 3341 E Queen Creek Rd Ste 105, Gilbert, AZ 85297-8510 | 2019-03-20 |
| 1700304110 | Psa Behavioral Health Agency | Community/Behavioral Health | 2580 Highway 95 Ste 116, Bullhead City, AZ 86442-7324 | 2017-09-06 |
| 1316304546 | Psa Behavioral Health Agency | Public Health or Welfare | 1308 N Stockton Hill Rd, Suite D, Kingman, AZ 86401-5139 | 2016-01-19 |
| 1467822734 | Psa Behavioral Health Agency | Public Health or Welfare | 4665 S Ash Ave Ste G-1, Tempe, AZ 85282-6765 | 2015-09-30 |
| 1477982395 | Psa Behavioral Health Agency | Public Health or Welfare | 541 E 10th St, Douglas, AZ 85607-2009 | 2013-11-01 |
| 1215362082 | Psa Behavioral Health Agency | Public Health or Welfare | 1326 W Highway 92, Suite K, Bisbee, AZ 85603-1151 | 2013-09-11 |
| 1265877500 | Psa Behavioral Health Agency | Public Health or Welfare | 820 S California Ave, Suite 104, Parker, AZ 85344-5051 | 2013-04-30 |
| 1184965840 | Psa Behavioral Health Agency | Public Health or Welfare | 220 E 6th St, Tucson, AZ 85705-8424 | 2013-03-06 |
| 1366786006 | Psa Behavioral Health Agency | Public Health or Welfare | 4655 S Lakeshore Dr, Tempe, AZ 85282-8328 | 2012-11-19 |
| Street Address |
1500 E 15TH ST ROOM 608 |
| City | DOUGLAS |
| State | AZ |
| Zip Code | 85607-1731 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1861454191 | Mitchell Paul Nelson | Specialist/Technologist | 1500 E 15th St, Douglas, AZ 85607-1731 | 2006-04-03 |
| 1053685396 | Tamara Danett Martinez | Licensed Practical Nurse | 1500 E 15th St, Douglas, AZ 85607-1731 | 2012-03-05 |
| 1467620567 | Richard C. Acosta | Student in an Organized Health Care Education/Training Program | 1500 E 15th St, Douglas, AZ 85607-1731 | 2008-02-12 |
| 1548440993 | Yolanda S Caruso | Registered Nurse | 1500 E 15th St, Douglas, AZ 85607-1731 | 2007-11-13 |
| 1871612861 | Janice Lee Fritsche | Occupational Therapist | 1500 E 15th St, Rm306, Douglas, AZ 85607-1731 | 2007-03-28 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1811472665 | Chiricahua Community Health Centers, Inc | Clinic/Center | 1151 16th Street, Douglas, AZ 85607 | 2018-09-27 |
| 1457758609 | Angela Leah Overturf | Nurse Practitioner | 100 East 5th Street, Douglas, AZ 85607 | 2014-12-02 |
| 1609279108 | Walter Tucker | Counselor | 2100 E 8th, Douglas, AZ 85607 | 2014-09-29 |
| 1851700488 | Gerardo Grijalva | Non-emergency Medical Transport (VAN) | 2714 E 6th St, Douglas, AZ 85607 | 2014-08-07 |
| 1174933246 | Caring Connections for Special Needs, LLC | Community/Behavioral Health | 1019 F Ave, Douglas, AZ 85607 | 2014-04-29 |
| 1831473164 | Cheryl Lynn Mcneeley | Speech-Language Pathologist | 815 E. 15th Street, Douglas, AZ 85607 | 2011-10-05 |
| 1245523364 | Community Intervention Associates | Community/Behavioral Health | 1701 North Douglasave, Douglas, AZ 85607 | 2011-05-23 |
| 1174820898 | Chiricahua Community Health Centers, Inc | Clinic/Center | 815 15th Street, Douglas, AZ 85607 | 2011-02-15 |
| 1033319512 | Community Healthcare of Douglas Inc | Clinic/Center | 1906 11th Street, Douglas, AZ 85607 | 2007-07-23 |
| 1538360888 | Jay Daniel Zamora | Chiropractor | 1915 E 10th St, Douglas, AZ 85607 | 2007-05-31 |
| Find all providers in zip 85607 | ||||
| Taxonomy Code | 251K00000X |
| Grouping | Agencies |
| Classification | Public Health or Welfare |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1700442753 | Region Xi Field Fiscal Office | Public Health or Welfare | 1400 Peterson Ave N Ste D, Douglas, GA 31533-2833 | 2019-05-15 |
| 1477982395 | Psa Behavioral Health Agency | Public Health or Welfare | 541 E 10th St, Douglas, AZ 85607-2009 | 2013-11-01 |
| 1316015316 | Southeastern Arizona Behavioral Health Services, Inc. | Public Health or Welfare | 1940 E 11th St, Douglas, AZ 85607-2413 | 2006-11-30 |
| 1255438651 | County of Converse | Public Health or Welfare | 442 Center, Douglas, WY 82633 | 2006-09-20 |
| 1316976699 | Coffee County Board of Health | Public Health or Welfare | 1003 Shirley Ave, Douglas, GA 31533-2123 | 2006-06-30 |
| 1225074685 | Town of Douglas | Public Health or Welfare | 29 Depot St, Douglas, MA 01516-2374 | 2006-06-22 |
| 1952346074 | Coffee County Board of Health | Public Health or Welfare | 1111 Baker Hwy W, Douglas, GA 31533-2107 | 2006-06-20 |
| 1124016019 | Southeastern Arizona Behavioral Health Services, Inc. | Public Health or Welfare | 1701 N Douglas Ave, Douglas, AZ 85607-1019 | 2005-10-13 |
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|---|---|---|---|---|
| 1548861701 | Agape Love Community Center LLC | Public Health or Welfare | 2750 W Mcdowell Rd, Phoenix, AZ 85009-2605 | 2020-11-04 |
| 1508481854 | Hamoecrc, LLC | Public Health or Welfare | 4413 N 106th Ave, Phoenix, AZ 85037-5563 | 2020-06-12 |
| 1699307306 | Arizona Healthcare Outreach | Public Health or Welfare | 3581 W Northern Ave Ste 8, Phoenix, AZ 85051-9404 | 2020-02-10 |
| 1962949008 | Dhew Ind Hlth Sv Hlth Svs & Mntl Hlth Adm | Public Health or Welfare | 1216 N. 307th Avenue, San Lucy Clinic, Gila Bend, AZ 85337 | 2017-01-27 |
| 1316484462 | Golder Ranch Fire District | Public Health or Welfare | 3885 E Golder Ranch Dr, Tucson, AZ 85739-9797 | 2017-01-27 |
| 1609226364 | Clean Colonic LLC | Public Health or Welfare | 7560 S. Willow Dr, Tempe, AZ 85283 | 2016-06-14 |
| 1316304546 | Psa Behavioral Health Agency | Public Health or Welfare | 1308 N Stockton Hill Rd, Suite D, Kingman, AZ 86401-5139 | 2016-01-19 |
| 1346606761 | Banner Whole Health Clinic | Public Health or Welfare | 535 N, Wimont, Tucson, AZ 85711 | 2016-01-14 |
| 1467822734 | Psa Behavioral Health Agency | Public Health or Welfare | 4665 S Ash Ave Ste G-1, Tempe, AZ 85282-6765 | 2015-09-30 |
| 1003207226 | Summit Fire District | Public Health or Welfare | 8905 Koch Field Rd, Flagstaff, AZ 86004-3261 | 2015-02-10 |
| Find all providers with the same taxonomy | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.