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General NPI Number Information
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NPI Number | 1497880439
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Entity Type | Organization
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Legal Business Name | GILA RIVER REGIONAL BEHAVIORAL HEALTH AUTHORITY
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Dates
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Enumeration Date | 02/22/2007
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Last Update Date | 08/15/2024
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Provider Practice Location Address
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Address Line | 483 W. SEED FARM ROAD
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City | SACATON
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State | AZ
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Zip | 85247-0038
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Country | US
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Telephone | 602-528-7135
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Fax | 602-528-1374
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Provider Business Mailing Address
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Address Line | PO BOX 38
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City | SACATON
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State | AZ
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Zip | 85247-0038
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Country | US
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Telephone | 602-528-7135
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Fax | 602-528-1374
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Authorized Official
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Title or Position | CEO
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Name | SCOTT GEMBERLING
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Credential |
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Telephone | 602-528-1200
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251S00000X
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Taxonomy Name | Community/Behavioral Health Agency
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License Number | TRIBAL CMS WAIVER
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License Number State | AZ
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