Provider Demographics
NPI:1215475876
Name:FAMILY & BEHAVIORAL HEALTH CONCEPTS, LLC
Entity type:Organization
Organization Name:FAMILY & BEHAVIORAL HEALTH CONCEPTS, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO/ADVANCED PRACTICE NURSE
Authorized Official - Prefix:
Authorized Official - First Name:RABANY
Authorized Official - Middle Name:
Authorized Official - Last Name:CLAYBORN
Authorized Official - Suffix:
Authorized Official - Credentials:APNP
Authorized Official - Phone:414-375-0478
Mailing Address - Street 1:2945 N 53RD ST
Mailing Address - Street 2:
Mailing Address - City:MILWAUKEE
Mailing Address - State:WI
Mailing Address - Zip Code:53210-1616
Mailing Address - Country:US
Mailing Address - Phone:414-375-0478
Mailing Address - Fax:414-375-4048
Practice Address - Street 1:8532 W CAPITOL DR
Practice Address - Street 2:
Practice Address - City:MILWAUKEE
Practice Address - State:WI
Practice Address - Zip Code:53222-1848
Practice Address - Country:US
Practice Address - Phone:414-375-0478
Practice Address - Fax:414-375-4048
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-02-03
Last Update Date:2017-02-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261Q00000XAmbulatory Health Care FacilitiesClinic/Center