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NPI Code Detail

MEDICARE: ASSOCIATED BEHAVIORAL HEALTH SERVICES INC

MEDICARE: ASSOCIATED BEHAVIORAL HEALTH 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
1103T00000XPsychologist
2106H00000XMarriage & Family Therapist
3101YM0800XMental Health Counselor

General Provider Information

NPI Number : 1861744062
Entity Type Code : Organization
Provider Name (Legal Business Name) : ASSOCIATED BEHAVIORAL HEALTH SERVICES INC
Provider Business Mailing Address
First Line : 2809 E DUPONT RD
Second Line :
City : FORT WAYNE
State : IN
Zip : 46825-1668
Country : US
Telephone Number : 260-755-1894
Fax Number :
Provider Business Practice Location Address
First Line : 2809 E DUPONT RD
Second Line :
City : FORT WAYNE
State : IN
Zip : 46825-1668
Country : US
Telephone Number : 260-755-1894
Fax Number :
Authorized Official
Title or Position : PRESIDENT/COO
Name : MR. AKINLANA DADA
Credential :
Telephone Number : 260-755-1894
Provider Enumeration Date : 10/11/2012
Last Update Date : 10/11/2012

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Directions to “ASSOCIATED BEHAVIORAL HEALTH SERVICES INC ” Practice Location

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