Provider Demographics
NPI:1104528348
Name:THE ABC GROUP, L.L.C.
Entity type:Organization
Organization Name:THE ABC GROUP, L.L.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:FOUNDER & OWNER
Authorized Official - Prefix:
Authorized Official - First Name:JUAN
Authorized Official - Middle Name:RAFAEL
Authorized Official - Last Name:MESA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:503-780-0292
Mailing Address - Street 1:32663 BUSH GARDEN DR
Mailing Address - Street 2:
Mailing Address - City:HARRISBURG
Mailing Address - State:OR
Mailing Address - Zip Code:97446-9751
Mailing Address - Country:US
Mailing Address - Phone:503-780-0292
Mailing Address - Fax:503-296-5396
Practice Address - Street 1:32663 BUSH GARDEN DR
Practice Address - Street 2:
Practice Address - City:HARRISBURG
Practice Address - State:OR
Practice Address - Zip Code:97446-9751
Practice Address - Country:US
Practice Address - Phone:503-780-0292
Practice Address - Fax:503-296-5396
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-03-21
Last Update Date:2023-03-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior AnalystGroup - Multi-Specialty