Provider Demographics
NPI:1649076407
Name:ADVANCED BEHAVIORAL HEALTH LLC
Entity type:Organization
Organization Name:ADVANCED BEHAVIORAL HEALTH LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:MS
Authorized Official - First Name:MARIAH
Authorized Official - Middle Name:
Authorized Official - Last Name:PINNICK
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:480-648-9522
Mailing Address - Street 1:25786 N DESERT MESA DR
Mailing Address - Street 2:
Mailing Address - City:SURPRISE
Mailing Address - State:AZ
Mailing Address - Zip Code:85387-6827
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:25786 N DESERT MESA DR
Practice Address - Street 2:
Practice Address - City:SURPRISE
Practice Address - State:AZ
Practice Address - Zip Code:85387-6827
Practice Address - Country:US
Practice Address - Phone:480-648-9522
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-02-21
Last Update Date:2025-02-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health