Healthcare Provider Details

I. General information

NPI: 1659293199
Provider Name (Legal Business Name): AMANA BEHAVIORAL HEALTH LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/27/2026
Last Update Date: 07/27/2026
Certification Date: 07/14/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5034 FALSTONE DR
CHARLOTTE NC
28269-0298
US

IV. Provider business mailing address

3020I PROSPERITY CHURCH RD # 1016
CHARLOTTE NC
28269-8112
US

V. Phone/Fax

Practice location:
  • Phone: 980-890-7008
  • Fax:
Mailing address:
  • Phone: 980-890-7008
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103K00000X
TaxonomyBehavior Analyst
License Number
License Number State

VIII. Authorized Official

Name: SYIFANI ARIFUN
Title or Position: OWNER
Credential: MA, BCBA, LBA
Phone: 980-890-7008