Healthcare Provider Details

I. General information

NPI: 1124518881
Provider Name (Legal Business Name): AMERICAN BEHAVIORAL HEALTH SYSTEMS, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/17/2018
Last Update Date: 05/17/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5548 MYRTLE AVE STE 202
FREELAND WA
98249-8776
US

IV. Provider business mailing address

PO BOX 141106
SPOKANE VALLEY WA
99214-1106
US

V. Phone/Fax

Practice location:
  • Phone: 509-232-5766
  • Fax: 509-321-5472
Mailing address:
  • Phone: 509-232-5766
  • Fax: 509-321-5472

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QR0405X
TaxonomySubstance Use Disorder Rehabilitation Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: TIFFANY DAWN STRETCH
Title or Position: CFO
Credential:
Phone: 509-232-5766