Provider Demographics
NPI:1689976276
Name:ASSOCIATED BEHAVIORAL HEALTH CARE
Entity type:Organization
Organization Name:ASSOCIATED BEHAVIORAL HEALTH CARE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:VICE PRESIDENT OF DEVELOPEMENT
Authorized Official - Prefix:
Authorized Official - First Name:JENNIFER
Authorized Official - Middle Name:R
Authorized Official - Last Name:MARS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:425-646-7279
Mailing Address - Street 1:1800 112TH AVE NE
Mailing Address - Street 2:SUITE 150W
Mailing Address - City:BELLEVUE
Mailing Address - State:WA
Mailing Address - Zip Code:98004-2993
Mailing Address - Country:US
Mailing Address - Phone:425-646-7279
Mailing Address - Fax:425-646-7499
Practice Address - Street 1:1215 120TH AVE NE
Practice Address - Street 2:STE 201
Practice Address - City:BELLEVUE
Practice Address - State:WA
Practice Address - Zip Code:98005-2135
Practice Address - Country:US
Practice Address - Phone:425-646-7279
Practice Address - Fax:425-646-7499
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-12-02
Last Update Date:2010-12-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologistGroup - Multi-Specialty