Provider Demographics
NPI:1609528314
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:OWNER/ADMINISTRATOR
Authorized Official - Prefix:DR
Authorized Official - First Name:OMETRIS
Authorized Official - Middle Name:E
Authorized Official - Last Name:KING
Authorized Official - Suffix:
Authorized Official - Credentials:DBH, LPC
Authorized Official - Phone:480-352-5490
Mailing Address - Street 1:5045 W BASELINE RD # 105-179
Mailing Address - Street 2:
Mailing Address - City:LAVEEN
Mailing Address - State:AZ
Mailing Address - Zip Code:85339-7392
Mailing Address - Country:US
Mailing Address - Phone:480-352-5490
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:480-352-5490
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-01-24
Last Update Date:2022-01-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes324500000XResidential Treatment FacilitiesSubstance Abuse Rehabilitation Facility