Provider Demographics
NPI:1699513143
Name:ABSOLUTE BEHAVIORAL HEALTH LLC
Entity type:Organization
Organization Name:ABSOLUTE BEHAVIORAL HEALTH LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:SADIYA
Authorized Official - Middle Name:HUSSEIN
Authorized Official - Last Name:HAILLE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:612-438-7661
Mailing Address - Street 1:940 INDUSTRIAL DR S STE 109
Mailing Address - Street 2:
Mailing Address - City:SAUK RAPIDS
Mailing Address - State:MN
Mailing Address - Zip Code:56379-1271
Mailing Address - Country:US
Mailing Address - Phone:612-438-7661
Mailing Address - Fax:
Practice Address - Street 1:940 INDUSTRIAL DR S STE 109
Practice Address - Street 2:
Practice Address - City:SAUK RAPIDS
Practice Address - State:MN
Practice Address - Zip Code:56379-1271
Practice Address - Country:US
Practice Address - Phone:612-438-7661
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-07-18
Last Update Date:2024-11-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261Q00000XAmbulatory Health Care FacilitiesClinic/Center