Provider Demographics
NPI:1558143685
Name:SABA INTEGRATED BEHAVIORAL HEALTH SERVICES, LLC
Entity Type:Organization
Organization Name:SABA INTEGRATED BEHAVIORAL HEALTH SERVICES, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:DR
Authorized Official - First Name:OMETRIS
Authorized Official - Middle Name:
Authorized Official - Last Name:KING
Authorized Official - Suffix:
Authorized Official - Credentials:DBH LPC
Authorized Official - Phone:602-772-0777
Mailing Address - Street 1:2150 E BRIARWOOD TER
Mailing Address - Street 2:
Mailing Address - City:PHOENIX
Mailing Address - State:AZ
Mailing Address - Zip Code:85048-8111
Mailing Address - Country:US
Mailing Address - Phone:602-772-0777
Mailing Address - Fax:
Practice Address - Street 1:2150 E BRIARWOOD TER
Practice Address - Street 2:
Practice Address - City:PHOENIX
Practice Address - State:AZ
Practice Address - Zip Code:85048-8111
Practice Address - Country:US
Practice Address - Phone:602-772-0777
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:SABA INTEGRATED BEHAVIORAL HEALTH SERVICES
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2023-10-13
Last Update Date:2023-10-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessionalGroup - Single Specialty