Basic Information
| Provider Information | |||||||||
| NPI: | 1215286851 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | ABHS SPECIALITY SERVICES 1 LLC | ||||||||
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| Mailing Information | |||||||||
| Address1: | PO BOX 9977 | ||||||||
| Address2: | |||||||||
| City: | SPOKANE | ||||||||
| State: | WA | ||||||||
| PostalCode: | 992090977 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5092325766 | ||||||||
| FaxNumber: | 5092325770 | ||||||||
| Practice Location | |||||||||
| Address1: | 44 E COZZA DR | ||||||||
| Address2: | |||||||||
| City: | SPOKANE | ||||||||
| State: | WA | ||||||||
| PostalCode: | 992086514 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5092325766 | ||||||||
| FaxNumber: | 5092325770 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 08/29/2012 | ||||||||
| LastUpdateDate: | 08/29/2012 | ||||||||
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| AuthorizedOfficialLastName: | ROBERTSON | ||||||||
| AuthorizedOfficialFirstName: | TERESA | ||||||||
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| AuthorizedOfficialTitleorPosition: | FINANCE MANAGER | ||||||||
| AuthorizedOfficialTelephone: | 5092325766 | ||||||||
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| IsOrganizationSubpart: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 324500000X | 603230354 | WA | Y | Residential Treatment Facilities | Substance Abuse Rehabilitation Facility |
No ID Information.