Provider Demographics
NPI:1558561399
Name:ACCOUNTABLE BEHAVIORAL HEALTH ALLIANCE
Entity Type:Organization
Organization Name:ACCOUNTABLE BEHAVIORAL HEALTH ALLIANCE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OPERATIONS MANAGER
Authorized Official - Prefix:MS
Authorized Official - First Name:VALERIE
Authorized Official - Middle Name:
Authorized Official - Last Name:DAVIS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:541-753-8997
Mailing Address - Street 1:310 NW 5TH ST
Mailing Address - Street 2:SUITE 206
Mailing Address - City:CORVALLIS
Mailing Address - State:OR
Mailing Address - Zip Code:97330-4842
Mailing Address - Country:US
Mailing Address - Phone:541-753-8997
Mailing Address - Fax:541-752-4877
Practice Address - Street 1:310 NW 5TH ST
Practice Address - Street 2:SUITE 206
Practice Address - City:CORVALLIS
Practice Address - State:OR
Practice Address - Zip Code:97330-4842
Practice Address - Country:US
Practice Address - Phone:541-753-8997
Practice Address - Fax:541-752-4877
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-07-19
Last Update Date:2007-07-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes302R00000XManaged Care OrganizationsHealth Maintenance Organization