| Destined For Dignity Aba Llc | |
|
3660 Coyote Rd West Sacramento CA 95691-5465 | |
| (530) 204-8735 | |
| Not Available |
| Full Name | Destined For Dignity Aba Llc |
|---|---|
| Speciality | Behavior Analyst |
| Location | 3660 Coyote Rd, West Sacramento, California |
| Authorized Official Name and Position | Amenaghawon Ahmad (CLINICAL DIRECTOR/CEO) |
| Authorized Official Contact | 9164009043 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Destined For Dignity Aba Llc 1601 Merkley Ave Unit 656 West Sacramento CA 95691-7727 Ph: (916) 400-9043 | Destined For Dignity Aba Llc 3660 Coyote Rd West Sacramento CA 95691-5465 Ph: (530) 204-8735 |
| NPI Number | 1578177168 |
|---|---|
| Provider Enumeration Date | 09/02/2020 |
| Last Update Date | 10/08/2020 |
| Certification Date | 10/08/2020 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1578177168 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 103K00000X | Behavior Analyst | (* (Not Available)) | Primary |
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