Healthcare Provider Details

I. General information

NPI: 1982087813
Provider Name (Legal Business Name): SABREE THERAPEUTIC SERVICES, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/09/2015
Last Update Date: 05/28/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4131 CARMICHAEL RD STE 9
MONTGOMERY AL
36106
US

IV. Provider business mailing address

PO BOX 240912
MONTGOMERY AL
36124-0912
US

V. Phone/Fax

Practice location:
  • Phone: 334-318-1584
  • Fax: 334-593-4652
Mailing address:
  • Phone: 334-318-1584
  • Fax: 334-649-4099

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number1204-3776C
License Number StateAL
# 2
Primary TaxonomyN
Taxonomy Code251B00000X
TaxonomyCase Management Agency
License Number1204-3776C
License Number StateAL
# 3
Primary TaxonomyN
Taxonomy Code251S00000X
TaxonomyCommunity/Behavioral Health Agency
License Number1204-3776C
License Number StateAL

VIII. Authorized Official

Name: MR. MIKAL SABREE
Title or Position: OWNER
Credential: LICSW, PIP
Phone: 334-318-1584