Provider Demographics
NPI:1396184941
Name:A1 BEHAVIORAL HEALTH, LLC
Entity Type:Organization
Organization Name:A1 BEHAVIORAL HEALTH, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:PETER
Authorized Official - Middle Name:
Authorized Official - Last Name:SOLODOKO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:941-925-3490
Mailing Address - Street 1:20880 W DIXIE HWY
Mailing Address - Street 2:SUITE 106
Mailing Address - City:AVENTURA
Mailing Address - State:FL
Mailing Address - Zip Code:33180-1151
Mailing Address - Country:US
Mailing Address - Phone:305-933-9565
Mailing Address - Fax:305-933-8105
Practice Address - Street 1:20880 W DIXIE HWY
Practice Address - Street 2:SUITE 106
Practice Address - City:AVENTURA
Practice Address - State:FL
Practice Address - Zip Code:33180-1151
Practice Address - Country:US
Practice Address - Phone:305-933-9565
Practice Address - Fax:305-933-8105
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-06-17
Last Update Date:2013-07-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QR0405XAmbulatory Health Care FacilitiesClinic/CenterRehabilitation, Substance Use Disorder