| Blue Aba Nc Llc | |
|
525 N Tryon St Ste 1600 Charlotte NC 28202-0213 | |
| (980) 233-8107 | |
| (512) 813-5917 |
| Full Name | Blue Aba Nc Llc |
|---|---|
| Speciality | Community/behavioral Health |
| Location | 525 N Tryon St Ste 1600, Charlotte, North Carolina |
| 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 Nc Llc 3921 Alton Rd Unit 107 Miami Beach FL 33140-3852 Ph: (786) 521-1587 | Blue Aba Nc Llc 525 N Tryon St Ste 1600 Charlotte NC 28202-0213 Ph: (980) 233-8107 |
| NPI Number | 1073361986 |
|---|---|
| Provider Enumeration Date | 05/07/2024 |
| Last Update Date | 06/27/2024 |
| Certification Date | 06/27/2024 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1073361986 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 103K00000X | Behavior Analyst | (* (Not Available)) | Secondary |
| 251S00000X | Community/behavioral Health | (* (Not Available)) | Primary |
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