MEDICARE: LUKE'S HOUSE FOR BEHAVIORAL HEALTH

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	101YM0800X	Mental Health Counselor
2	251S00000X	Community/Behavioral Health Agency

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1265229793
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	LUKE'S HOUSE FOR BEHAVIORAL HEALTH

Provider Business Mailing Address
First Line	:	708 N SUNSHINE BLVD
Second Line	:
City	:	ELOY
State	:	AZ
Zip	:	85131-2142
Country	:	US
Telephone Number	:	520-208-0063
Fax Number	:	520-542-2400

Provider Business Practice Location Address
First Line	:	99 N E ST
Second Line	:
City	:	ELOY
State	:	AZ
Zip	:	85131-2422
Country	:	US
Telephone Number	:	520-866-1532
Fax Number	:

Authorized Official
Title or Position	:	ADMINISTRATIVE DIRECTOR
Name	:	SONNETTE CHERRY FEDERICO
Credential	:
Telephone Number	:	520-208-0063

Provider Enumeration Date	:	04/21/2025
Last Update Date	:	02/05/2026

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Directions to “LUKE'S HOUSE FOR BEHAVIORAL HEALTH ” Practice Location

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