Organization
ABRA HEALTH LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DA'MOND O GADSON DBH, LPC, MPC, MED (PRESIDENT)
(602) 518-0214
Entity
Organization
Contact information
Practice address
1401 E JEFFERSON ST, PHOENIX, AZ 85034-2315
(602) 492-1875
Mailing address
7214 W READE AVE, GLENDALE, AZ 85303-6124
(602) 518-0214
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
—
—
101YP2500X
Professional Counselor
—
—
251C00000X
Developmentally Disabled Services Day Training Agency
—
—
251K00000X
Public Health or Welfare Agency
—
—
251S00000X
Community/Behavioral Health Agency
—
—
261QC1500X
Community Health Clinic/Center
Primary
—
—
261QH0100X
Health Service Clinic/Center
—
—
261QR0401X
Comprehensive Outpatient Rehabilitation Facility (CORF)
—
—
385HR2065X
Child Physical Disabilities Respite Care
—
—
Other
Enumeration date
02/20/2024
Last updated
02/20/2024
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