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NPI Code Detail

MEDICARE: ABLE MENTAL HEALTH SERVICES LLC

MEDICARE: ABLE MENTAL HEALTH SERVICES 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
1251S00000XCommunity/Behavioral Health AgencyLPC10229AZ

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
112080785OTHERAZCAQH

General Provider Information

NPI Number : 1902216195
Entity Type Code : Organization
Provider Name (Legal Business Name) : ABLE MENTAL HEALTH SERVICES LLC
Provider Business Mailing Address
First Line : 202 E MCDOWELL RD STE 135
Second Line :
City : PHOENIX
State : AZ
Zip : 85004-4533
Country : US
Telephone Number : 602-696-2801
Fax Number :
Provider Business Practice Location Address
First Line : 202 E MCDOWELL RD STE 135
Second Line :
City : PHOENIX
State : AZ
Zip : 85004-4533
Country : US
Telephone Number : 602-696-2801
Fax Number :
Authorized Official
Title or Position : CEO
Name : CARLOS F. TOSCA
Credential : LPC
Telephone Number : 602-696-2801
Provider Enumeration Date : 04/28/2014
Last Update Date : 04/28/2014

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