Provider Demographics
NPI:1861194672
Name:SAHABA INITIATIVE
Entity type:Organization
Organization Name:SAHABA INITIATIVE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:MALEK
Authorized Official - Middle Name:
Authorized Official - Last Name:BENDELHOUM
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:909-381-3002
Mailing Address - Street 1:1887 BUSINESS CENTER DR STE 3A
Mailing Address - Street 2:
Mailing Address - City:SAN BERNARDINO
Mailing Address - State:CA
Mailing Address - Zip Code:92408-3445
Mailing Address - Country:US
Mailing Address - Phone:909-381-3002
Mailing Address - Fax:
Practice Address - Street 1:1887 BUSINESS CENTER DR STE 3A
Practice Address - Street 2:
Practice Address - City:SAN BERNARDINO
Practice Address - State:CA
Practice Address - Zip Code:92408-3445
Practice Address - Country:US
Practice Address - Phone:909-381-3002
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-03-17
Last Update Date:2023-03-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes252Y00000XAgenciesEarly Intervention Provider Agency
No251B00000XAgenciesCase Management