MEDICARE: ABU BEHAVIORAL AND HEALTH 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	261QM0855X	Adolescent and Children Mental Health Clinic/Center

General Provider Information

NPI Number	:	1770295040
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	ABU BEHAVIORAL AND HEALTH LLC

Provider Business Mailing Address
First Line	:	9894 BISSONNET ST STE 388
Second Line	:
City	:	HOUSTON
State	:	TX
Zip	:	77036-8273
Country	:	US
Telephone Number	:	832-897-6271
Fax Number	:	--

Provider Business Practice Location Address
First Line	:	9894 BISSONNET ST STE 388
Second Line	:
City	:	HOUSTON
State	:	TX
Zip	:	77036-8273
Country	:	US
Telephone Number	:	832-897-6271
Fax Number	:	--

Authorized Official
Title or Position	:	CHIEF EXECUTIVE OFFICER/OWNER
Name	:	MS. KIMBERLY DVONNE WRIGHT
Credential	:
Telephone Number	:	832-897-6271

Provider Enumeration Date	:	12/19/2022
Last Update Date	:	12/19/2022

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