MEDICARE: ADVANCED BEHAVIORAL HEALTH CARE SERVICES, INC.

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	251300000X	Local Education Agency (LEA)

General Provider Information

NPI Number	:	1780088237
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	ADVANCED BEHAVIORAL HEALTH CARE SERVICES, INC.

Provider Business Mailing Address
First Line	:	3213 BINZ ST
Second Line	:
City	:	HOUSTON
State	:	TX
Zip	:	77004-7813
Country	:	US
Telephone Number	:	713-644-8280
Fax Number	:	713-644-2991

Provider Business Practice Location Address
First Line	:	3213 BINZ ST
Second Line	:
City	:	HOUSTON
State	:	TX
Zip	:	77004-7813
Country	:	US
Telephone Number	:	713-644-8280
Fax Number	:	713-644-2991

Authorized Official
Title or Position	:	CEO
Name	:	MR. LONNIE LEE JACKSON
Credential	:
Telephone Number	:	713-644-8280

Provider Enumeration Date	:	10/13/2014
Last Update Date	:	03/06/2019

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