Provider Demographics
NPI:1376024091
Name:ASCEND BEHAVIORAL HEALTH AND WELLNESS,LLC
Entity Type:Organization
Organization Name:ASCEND BEHAVIORAL HEALTH AND WELLNESS,LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:ROBERTA
Authorized Official - Middle Name:
Authorized Official - Last Name:ABDALLAH
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:602-460-1449
Mailing Address - Street 1:27818 N 24TH LN
Mailing Address - Street 2:
Mailing Address - City:PHOENIX
Mailing Address - State:AZ
Mailing Address - Zip Code:85085-4706
Mailing Address - Country:US
Mailing Address - Phone:602-471-5053
Mailing Address - Fax:602-926-0590
Practice Address - Street 1:1812 W HORSETAIL TRL
Practice Address - Street 2:
Practice Address - City:PHOENIX
Practice Address - State:AZ
Practice Address - Zip Code:85085-8039
Practice Address - Country:US
Practice Address - Phone:602-471-5053
Practice Address - Fax:602-926-0590
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-08-22
Last Update Date:2018-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health