Basic Information
| Provider Information | |||||||||
| NPI: | 1598255267 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | AMERICAN BEHAVIORAL HEALT SYSTEMS, INC. | ||||||||
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| OtherOrganizationName: | AMERICAN BEHAVIORAL HEALTH SYSTEMS - STANWOOD OP | ||||||||
| OtherOrganizationType: | 5 | ||||||||
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| Mailing Information | |||||||||
| Address1: | PO BOX 141106 | ||||||||
| Address2: | |||||||||
| City: | SPOKANE VALLEY | ||||||||
| State: | WA | ||||||||
| PostalCode: | 992141106 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5092325766 | ||||||||
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| Practice Location | |||||||||
| Address1: | 7208 267TH ST NW STE A-100 | ||||||||
| Address2: | |||||||||
| City: | STANWOOD | ||||||||
| State: | WA | ||||||||
| PostalCode: | 982926289 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5092325766 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 05/17/2018 | ||||||||
| LastUpdateDate: | 05/17/2018 | ||||||||
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| AuthorizedOfficialLastName: | STRETCH | ||||||||
| AuthorizedOfficialFirstName: | TIFFANY | ||||||||
| AuthorizedOfficialMiddleName: | DAWN | ||||||||
| AuthorizedOfficialTitleorPosition: | CFO | ||||||||
| AuthorizedOfficialTelephone: | 5092325766 | ||||||||
| IsSoleProprietor: | |||||||||
| IsOrganizationSubpart: | Y | ||||||||
| ParentOrganizationLBN: | AMERICAN BEHAVIORAL HEALTH SYSTEMS, INC. | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 261QR0405X | Y | Ambulatory Health Care Facilities | Clinic/Center | Rehabilitation, Substance Use Disorder |
No ID Information.