Provider Demographics
NPI:1033688833
Name:ABM COUNSELING CENTER LLC
Entity Type:Organization
Organization Name:ABM COUNSELING CENTER LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MR
Authorized Official - First Name:ANGEL
Authorized Official - Middle Name:LUIS
Authorized Official - Last Name:TORRES
Authorized Official - Suffix:
Authorized Official - Credentials:MSW, MCAP
Authorized Official - Phone:386-338-8103
Mailing Address - Street 1:4750 E MOODY BLVD STE 209
Mailing Address - Street 2:
Mailing Address - City:BUNNELL
Mailing Address - State:FL
Mailing Address - Zip Code:32110-7711
Mailing Address - Country:US
Mailing Address - Phone:386-338-8013
Mailing Address - Fax:
Practice Address - Street 1:4750 E MOODY BLVD STE 209
Practice Address - Street 2:
Practice Address - City:BUNNELL
Practice Address - State:FL
Practice Address - Zip Code:32110-7711
Practice Address - Country:US
Practice Address - Phone:386-338-8013
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-11-21
Last Update Date:2018-11-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health