Provider Demographics
NPI:1619276557
Name:AFFORDABLE BEHAVIORAL HEALTH SERVICES OF FL. INC.
Entity Type:Organization
Organization Name:AFFORDABLE BEHAVIORAL HEALTH SERVICES OF FL. INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MS
Authorized Official - First Name:BONNIE
Authorized Official - Middle Name:LEE
Authorized Official - Last Name:CHRISTENSEN
Authorized Official - Suffix:
Authorized Official - Credentials:LMHC
Authorized Official - Phone:813-935-4515
Mailing Address - Street 1:2630 W. WATERS AVE.
Mailing Address - Street 2:SUITE B.
Mailing Address - City:TAMPA
Mailing Address - State:FL
Mailing Address - Zip Code:33614
Mailing Address - Country:US
Mailing Address - Phone:813-935-4515
Mailing Address - Fax:
Practice Address - Street 1:2630 W WATERS AVE
Practice Address - Street 2:SUITE B
Practice Address - City:TAMPA
Practice Address - State:FL
Practice Address - Zip Code:33614-2511
Practice Address - Country:US
Practice Address - Phone:813-935-4515
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-03-17
Last Update Date:2011-03-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLMH10005101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessionalGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL1972837656Other01 NPI NUMBER