Provider Demographics
NPI:1164404398
Name:ABC BEHAVIORAL HEALTH, L.L.C.
Entity Type:Organization
Organization Name:ABC BEHAVIORAL HEALTH, L.L.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT, CEO
Authorized Official - Prefix:MRS
Authorized Official - First Name:MELODIE
Authorized Official - Middle Name:
Authorized Official - Last Name:SHATZER
Authorized Official - Suffix:
Authorized Official - Credentials:EDD
Authorized Official - Phone:214-275-8500
Mailing Address - Street 1:4600 SAMUELL BLVD
Mailing Address - Street 2:
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75228-6874
Mailing Address - Country:US
Mailing Address - Phone:214-275-8500
Mailing Address - Fax:214-275-6990
Practice Address - Street 1:4600 SAMUELL BLVD
Practice Address - Street 2:
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75228-6874
Practice Address - Country:US
Practice Address - Phone:214-275-8500
Practice Address - Fax:214-275-6990
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-11-15
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Not Answered101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)Group - Multi-Specialty
Not Answered101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX00846TMedicare ID - Type Unspecified