Provider Demographics
NPI:1730702978
Name:ABLE BEHAVIORAL HEALTH CENTER
Entity type:Organization
Organization Name:ABLE BEHAVIORAL HEALTH CENTER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CLINICIAN
Authorized Official - Prefix:
Authorized Official - First Name:REBECCA
Authorized Official - Middle Name:
Authorized Official - Last Name:BELIZAIRE
Authorized Official - Suffix:
Authorized Official - Credentials:LMHC
Authorized Official - Phone:702-381-2121
Mailing Address - Street 1:337 WASHINGTON ST UNIT 81631
Mailing Address - Street 2:
Mailing Address - City:WELLESLEY HILLS
Mailing Address - State:MA
Mailing Address - Zip Code:02481-8121
Mailing Address - Country:US
Mailing Address - Phone:702-381-2121
Mailing Address - Fax:855-495-0086
Practice Address - Street 1:ORANGE BLOSSOM MANOR MB4 P92
Practice Address - Street 2:BLK 8
Practice Address - City:INTERLACHEN
Practice Address - State:FL
Practice Address - Zip Code:32148
Practice Address - Country:US
Practice Address - Phone:702-381-2121
Practice Address - Fax:855-495-0086
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-05-22
Last Update Date:2020-05-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes261QM0801XAmbulatory Health Care FacilitiesClinic/CenterMental Health (Including Community Mental Health Center)
No163WC0400XNursing Service ProvidersRegistered NurseCase ManagementGroup - Multi-Specialty
No163WP0808XNursing Service ProvidersRegistered NursePsychiatric/Mental HealthGroup - Multi-Specialty
No261QM0850XAmbulatory Health Care FacilitiesClinic/CenterAdult Mental Health
No261QM0855XAmbulatory Health Care FacilitiesClinic/CenterAdolescent and Children Mental Health
No261QP2300XAmbulatory Health Care FacilitiesClinic/CenterPrimary Care