MEDICARE: ABSOLUTE BEHAVIOR HEALTH CARE LLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	261QD1600X	Developmental Disabilities Clinic/Center

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1043880636
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	ABSOLUTE BEHAVIOR HEALTH CARE LLC

Provider Business Mailing Address
First Line	:	1051 TIFFANY SOUTH
Second Line	:
City	:	YOUNGSTOWN
State	:	OH
Zip	:	44514-1977
Country	:	US
Telephone Number	:	330-629-2955
Fax Number	:	330-629-2956

Provider Business Practice Location Address
First Line	:	1051 TIFFANY SOUTH
Second Line	:
City	:	YOUNGSTOWN
State	:	OH
Zip	:	44514-1977
Country	:	US
Telephone Number	:	330-629-2955
Fax Number	:	330-629-2956

Authorized Official
Title or Position	:	DIRECTOR
Name	:	DR. JULIE A KNAPP
Credential	:	PHD
Telephone Number	:	330-629-2955

Provider Enumeration Date	:	06/28/2021
Last Update Date	:	07/18/2024

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