Healthcare Provider Details

I. General information

NPI: 1497588743
Provider Name (Legal Business Name): AMAN BEHAVIORAL SERVICES LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/22/2024
Last Update Date: 08/22/2024
Certification Date: 08/22/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4124 QUEBEC AVE N STE 302A
NEW HOPE MN
55427-1241
US

IV. Provider business mailing address

4124 QUEBEC AVE N STE 302A
NEW HOPE MN
55427-1241
US

V. Phone/Fax

Practice location:
  • Phone: 206-227-4063
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code252Y00000X
TaxonomyEarly Intervention Provider Agency
License Number
License Number State

VIII. Authorized Official

Name: ABDULRAOUF BAHEZA
Title or Position: CEO
Credential:
Phone: 206-227-4063