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General NPI Number Information
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NPI Number | 1942874565
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Entity Type | Organization
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Legal Business Name | ASCELLUS BEHAVIORAL HEALTH PC
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Dates
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Enumeration Date | 05/18/2021
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Last Update Date | 05/18/2021
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Provider Practice Location Address
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Address Line | 1267 WILLIS ST STE 200
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City | REDDING
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State | CA
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Zip | 96001-0400
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Country | US
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Telephone | 561-832-4999
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Fax | 561-833-9333
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Provider Business Mailing Address
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Address Line | 6801 LAKE WORTH RD STE 308
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City | GREENACRES
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State | FL
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Zip | 33467-2966
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Country | US
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Telephone | 561-601-3092
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Fax | 561-833-9333
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Authorized Official
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Title or Position | PRESIDENT
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Name | MR. DAVID A SACK
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Credential | MD
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Telephone | 561-832-4999
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QM2500X
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Taxonomy Name | Medical Specialty Clinic/Center
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License Number |
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License Number State |
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