| Blue Aba Arizona Llc | |
|
4600 E Washington St Ste 300 Phoenix AZ 85034-1908 | |
| (623) 335-4283 | |
| Not Available |
| Full Name | Blue Aba Arizona Llc |
|---|---|
| Speciality | Community/behavioral Health |
| Location | 4600 E Washington St Ste 300, Phoenix, Arizona |
| Authorized Official Name and Position | Gershon Fink (CEO) |
| Authorized Official Contact | 7865211587 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Blue Aba Arizona Llc 3921 Alton Rd Unit 107 Miami Beach FL 33140-3852 Ph: (786) 521-1587 | Blue Aba Arizona Llc 4600 E Washington St Ste 300 Phoenix AZ 85034-1908 Ph: (623) 335-4283 |
| NPI Number | 1255038667 |
|---|---|
| Provider Enumeration Date | 02/15/2023 |
| Last Update Date | 06/27/2024 |
| Certification Date | 12/29/2023 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1255038667 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 251S00000X | Community/behavioral Health | (* (Not Available)) | Primary |
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