Basic Information
Provider Information
NPI: 1437634888
EntityType: 2
ReplacementNPI:  
OrganizationName: AMERICAN BEHAVIORAL HEALT SYSTEMS, INC.
LastName:  
FirstName:  
MiddleName:  
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Credential:  
OtherOrganizationName:  
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Mailing Information
Address1: PO BOX 141106
Address2:  
City: SPOKANE VALLEY
State: WA
PostalCode: 992141106
CountryCode: US
TelephoneNumber: 5092325766
FaxNumber: 5093215472
Practice Location
Address1: 1230 MONITOR ST
Address2:  
City: WENATCHEE
State: WA
PostalCode: 988013534
CountryCode: US
TelephoneNumber: 5093001221
FaxNumber:  
Other Information
ProviderEnumerationDate: 10/02/2018
LastUpdateDate: 10/02/2018
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode:  
AuthorizedOfficialLastName: STRETCH
AuthorizedOfficialFirstName: TIFFANY
AuthorizedOfficialMiddleName: DAWN
AuthorizedOfficialTitleorPosition: CHIEF FINANCIAL OFFICER
AuthorizedOfficialTelephone: 5092325766
IsSoleProprietor:  
IsOrganizationSubpart: Y
ParentOrganizationLBN: AMERICAN BEHAVIORAL HEALT SYSTEMS, INC.
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential: CFO
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
251S00000X  Y AgenciesCommunity/Behavioral Health 

No ID Information.


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