Southeastern Arizona Behavioral Health Service, INC.
Community/Behavioral Health in Willcox, AZ. Organization (NPI-2).
NPI number1790773620
StatusActive
Last updated in NPPESSep 5, 2025
Details
- NPI
- 1790773620
- Entity type
- Organization (NPI-2)
- Legal business name
- Southeastern Arizona Behavioral Health Service, INC.
- Organization subpart
- No
- Enumeration date
- Oct 13, 2005
- Certification date
- Sep 5, 2025
- Last updated
- Sep 5, 2025
Medicare and OIG
- Medicare enrolled (PECOS)
- Not in the Medicare enrollment file
- Can order and refer
- Not on the CMS order and referring list
- OIG exclusion list
- This NPI is not listed
CMS and OIG files of November 2026. PECOS lookup · OIG exclusion check
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 251S00000X | Community/Behavioral Health | – | – | Yes |
| 251K00000X | Public Health or Welfare | BH-2672 | AZ |
Other names
- Seabhs Willcox Outpatient (Other Name)
Practice location
404 W Rex Allen DrWillcox, AZ 85643-1120
Phone 520-384-2521 · Fax 520-384-0543
Mailing address
611 W Union StBenson, AZ 85602-6718
Phone 520-586-0800 · Fax 520-586-0116
Authorized official
Kathy Guzman Wells
Evp/Coo
5208385501
Is something wrong?
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