Provider Demographics
NPI:1124599840
Name:ABLE MENTAL HEALTH AGENCY
Entity Type:Organization
Organization Name:ABLE MENTAL HEALTH AGENCY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:DEREK
Authorized Official - Middle Name:
Authorized Official - Last Name:CHAMBERLAIN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:603-997-6609
Mailing Address - Street 1:764 GOLDEN SEDUM DR
Mailing Address - Street 2:
Mailing Address - City:HENDERSON
Mailing Address - State:NV
Mailing Address - Zip Code:89011-2641
Mailing Address - Country:US
Mailing Address - Phone:603-997-6609
Mailing Address - Fax:
Practice Address - Street 1:764 GOLDEN SEDUM DR
Practice Address - Street 2:
Practice Address - City:HENDERSON
Practice Address - State:NV
Practice Address - Zip Code:89011-2641
Practice Address - Country:US
Practice Address - Phone:603-997-6609
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-12-06
Last Update Date:2018-12-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health