Organization
ABRA HEALTH LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. DA'MOND GADSON DBH, LPC, MED (OWNER)
(602) 518-0214
Entity
Organization
Contact information
Practice address
8636 N 59TH AVE, GLENDALE, AZ 85302-5404
(602) 518-0214
Mailing address
7214 W READE AVE, GLENDALE, AZ 85303-6124
(602) 518-0214
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
—
—
101YM0800X
Mental Health Counselor
—
—
251B00000X
Case Management Agency
—
—
251C00000X
Developmentally Disabled Services Day Training Agency
Primary
—
—
251E00000X
Home Health Agency
—
—
251K00000X
Public Health or Welfare Agency
—
—
253Z00000X
In Home Supportive Care Agency
—
—
261QA0600X
Adult Day Care Clinic/Center
—
—
261QC1500X
Community Health Clinic/Center
—
—
261QD1600X
Developmental Disabilities Clinic/Center
—
—
261QM0801X
Mental Health Clinic/Center (Including Community Mental Health Center)
—
—
261QM0850X
Adult Mental Health Clinic/Center
—
—
261QM0855X
Adolescent and Children Mental Health Clinic/Center
—
—
261QP2300X
Primary Care Clinic/Center
—
—
261QR0405X
Substance Use Disorder Rehabilitation Clinic/Center
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
008085
—
AZ
Enumeration date
04/23/2019
Last updated
08/14/2020
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