Provider Demographics
NPI:1265229793
Name:LUKE'S HOUSE FOR BEHAVIORAL HEALTH
Entity type:Organization
Organization Name:LUKE'S HOUSE FOR BEHAVIORAL HEALTH
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATIVE DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:SONNETTE
Authorized Official - Middle Name:
Authorized Official - Last Name:CHERRY FEDERICO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:520-208-0063
Mailing Address - Street 1:708 N SUNSHINE BLVD
Mailing Address - Street 2:
Mailing Address - City:ELOY
Mailing Address - State:AZ
Mailing Address - Zip Code:85131-2142
Mailing Address - Country:US
Mailing Address - Phone:520-208-0063
Mailing Address - Fax:
Practice Address - Street 1:708 N SUNSHINE BLVD
Practice Address - Street 2:
Practice Address - City:ELOY
Practice Address - State:AZ
Practice Address - Zip Code:85131-2142
Practice Address - Country:US
Practice Address - Phone:520-866-1532
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-04-21
Last Update Date:2025-05-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZ1477043792Medicaid
AZ384349Medicaid