Provider Demographics
NPI:1902216195
Name:ABLE MENTAL HEALTH SERVICES LLC
Entity Type:Organization
Organization Name:ABLE MENTAL HEALTH SERVICES LLC
Other - Org Name:ALIIANCE FOR BETTER LIVING EXPERIENCE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:CARLOS
Authorized Official - Middle Name:F
Authorized Official - Last Name:TOSCA
Authorized Official - Suffix:
Authorized Official - Credentials:LPC
Authorized Official - Phone:602-696-2801
Mailing Address - Street 1:202 E MCDOWELL RD STE 135
Mailing Address - Street 2:
Mailing Address - City:PHOENIX
Mailing Address - State:AZ
Mailing Address - Zip Code:85004-4533
Mailing Address - Country:US
Mailing Address - Phone:602-696-2801
Mailing Address - Fax:
Practice Address - Street 1:202 E MCDOWELL RD STE 135
Practice Address - Street 2:
Practice Address - City:PHOENIX
Practice Address - State:AZ
Practice Address - Zip Code:85004-4533
Practice Address - Country:US
Practice Address - Phone:602-696-2801
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-04-28
Last Update Date:2014-04-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZLPC10229251S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZ12080785OtherCAQH