Provider Demographics
NPI:1619360211
Name:ACCENTUATED BEHAVIORAL CONCEPTS AND INTEGRATED SOLUTIONS (ABC IS) LLC
Entity Type:Organization
Organization Name:ACCENTUATED BEHAVIORAL CONCEPTS AND INTEGRATED SOLUTIONS (ABC IS) LLC
Other - Org Name:ABC IS LLC
Other - Org Type:Other Name
Authorized Official - Title/Position:PRACTICE MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:ALINA
Authorized Official - Middle Name:
Authorized Official - Last Name:GRITSINA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:773-998-1353
Mailing Address - Street 1:3353 W WILSON AVE
Mailing Address - Street 2:APT 3R
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60625-5337
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:3353 W WILSON AVE
Practice Address - Street 2:APT 3R
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60625-5337
Practice Address - Country:US
Practice Address - Phone:773-998-1353
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-03-06
Last Update Date:2015-03-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior AnalystGroup - Single Specialty