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General NPI Number Information
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NPI Number | 1861869786
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Entity Type | Organization
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Legal Business Name | ABHS INC
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Dates
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Enumeration Date | 08/26/2015
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Last Update Date | 08/26/2015
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Provider Practice Location Address
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Address Line | 524 CLEVELAND BLVD 230
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City | CALDWELL
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State | ID
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Zip | 83605-4076
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Country | US
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Telephone | 205-455-1222
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Fax |
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Provider Business Mailing Address
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Address Line | 524 CLEVELAND BLVD 230
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City | CALDWELL
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State | ID
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Zip | 83605-4076
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Country | US
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Telephone | 205-455-1222
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Fax |
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Authorized Official
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Title or Position | ADMINISTRATOR
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Name | MR. RICHARD J JOHANNSEN
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Credential |
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Telephone | 208-455-1222
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251B00000X
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Taxonomy Name | Case Management Agency
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 251S00000X
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Taxonomy Name | Community/Behavioral Health Agency
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License Number | 152380008
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License Number State | ID
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