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NPI Code Detail

MEDICARE: ABS KIDS PC

MEDICARE: ABS KIDS PC
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
2251S00000XCommunity/Behavioral Health Agency

General Provider Information

NPI Number : 1952976490
Entity Type Code : Organization
Provider Name (Legal Business Name) : ABS KIDS PC
Provider Business Mailing Address
First Line : 16255 VENTURA BLVD STE 900
Second Line :
City : ENCINO
State : CA
Zip : 91436-2317
Country : US
Telephone Number : 801-770-1590
Fax Number : 818-650-1670
Provider Business Practice Location Address
First Line : 126 MAPLE ROW BLVD
Second Line :
City : HENDERSONVILLE
State : TN
Zip : 37075-3824
Country : US
Telephone Number : 615-549-6608
Fax Number : 615-905-9200
Authorized Official
Title or Position : VP,PAYOR CONTRACTING & DEVELOPMENT
Name : MR. ROBERT KEY JR.
Credential :
Telephone Number : 805-279-2893
Provider Enumeration Date : 05/26/2021
Last Update Date : 09/10/2025

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