Provider Demographics
NPI:1477610368
Name:ASSOCIATED BEHAVIORAL HEALTH CARE INC
Entity Type:Organization
Organization Name:ASSOCIATED BEHAVIORAL HEALTH CARE INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:ALEXANDER
Authorized Official - Middle Name:
Authorized Official - Last Name:BARD
Authorized Official - Suffix:
Authorized Official - Credentials:CDP
Authorized Official - Phone:425-646-7279
Mailing Address - Street 1:1800 112TH AVE NE
Mailing Address - Street 2:SUITE 150
Mailing Address - City:BELLEVUE
Mailing Address - State:WA
Mailing Address - Zip Code:98004-2993
Mailing Address - Country:US
Mailing Address - Phone:425-646-7279
Mailing Address - Fax:425-646-7499
Practice Address - Street 1:4711 44TH AVE SE
Practice Address - Street 2:SUITE A
Practice Address - City:SEATTLE
Practice Address - State:WA
Practice Address - Zip Code:98116-4591
Practice Address - Country:US
Practice Address - Phone:206-935-1282
Practice Address - Fax:425-671-6496
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-02
Last Update Date:2020-06-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WA045600101YA0400X
101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)Group - Multi-Specialty
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA=========OtherTAX IDENTIFICATION NUMBER