Provider Demographics
NPI:1588434310
Name:WABI SABI BEHAVIORAL HEALTH CENTER, LLC
Entity type:Organization
Organization Name:WABI SABI BEHAVIORAL HEALTH CENTER, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:CARLEY
Authorized Official - Middle Name:DON
Authorized Official - Last Name:STARLING
Authorized Official - Suffix:
Authorized Official - Credentials:PSYD, LP
Authorized Official - Phone:719-313-0559
Mailing Address - Street 1:1135 N LINCOLN AVE
Mailing Address - Street 2:
Mailing Address - City:HASTINGS
Mailing Address - State:NE
Mailing Address - Zip Code:68901-3855
Mailing Address - Country:US
Mailing Address - Phone:719-313-0559
Mailing Address - Fax:
Practice Address - Street 1:223 E 14TH ST STE 3
Practice Address - Street 2:
Practice Address - City:HASTINGS
Practice Address - State:NE
Practice Address - Zip Code:68901-3240
Practice Address - Country:US
Practice Address - Phone:402-460-0367
Practice Address - Fax:402-882-9100
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-01-03
Last Update Date:2024-03-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0801XAmbulatory Health Care FacilitiesClinic/CenterMental Health (Including Community Mental Health Center)
No261QD1600XAmbulatory Health Care FacilitiesClinic/CenterDevelopmental Disabilities
No261QM0855XAmbulatory Health Care FacilitiesClinic/CenterAdolescent and Children Mental Health