Provider Demographics
NPI:1720578487
Name:AMERICAN BEHAVIORAL HEALTH SYSTEMS, INC.
Entity Type:Organization
Organization Name:AMERICAN BEHAVIORAL HEALTH SYSTEMS, INC.
Other - Org Name:AMERICAN BEHAVIORAL HEALTH SYSTEMS CENTRALIA OUTPATIENT
Other - Org Type:Other Name
Authorized Official - Title/Position:CFO
Authorized Official - Prefix:
Authorized Official - First Name:TIFFANY
Authorized Official - Middle Name:DAWN
Authorized Official - Last Name:STRETCH
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:509-232-5766
Mailing Address - Street 1:PO BOX 141106
Mailing Address - Street 2:
Mailing Address - City:SPOKANE VALLEY
Mailing Address - State:WA
Mailing Address - Zip Code:99214-1106
Mailing Address - Country:US
Mailing Address - Phone:509-232-5766
Mailing Address - Fax:509-321-5472
Practice Address - Street 1:1723 KRESKY AVE
Practice Address - Street 2:
Practice Address - City:CENTRALIA
Practice Address - State:WA
Practice Address - Zip Code:98531-8985
Practice Address - Country:US
Practice Address - Phone:509-232-5766
Practice Address - Fax:509-321-5472
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:AMERICAN BEHAVIORAL HEALTH SYSTEMS, INC.
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2018-05-17
Last Update Date:2018-05-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health