Provider Demographics
NPI:1740098151
Name:ORANGE BEHAVIORAL HEALTH LLC
Entity type:Organization
Organization Name:ORANGE BEHAVIORAL HEALTH LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:OMAR
Authorized Official - Middle Name:
Authorized Official - Last Name:ABOUHALA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:407-946-0743
Mailing Address - Street 1:7200 LAKE ELLENOR DR STE 102
Mailing Address - Street 2:
Mailing Address - City:ORLANDO
Mailing Address - State:FL
Mailing Address - Zip Code:32809-5786
Mailing Address - Country:US
Mailing Address - Phone:407-946-0743
Mailing Address - Fax:
Practice Address - Street 1:7200 LAKE ELLENOR DR STE 102
Practice Address - Street 2:
Practice Address - City:ORLANDO
Practice Address - State:FL
Practice Address - Zip Code:32809-5786
Practice Address - Country:US
Practice Address - Phone:407-946-0743
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-12-19
Last Update Date:2024-12-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health