Organization
ACADEMIC & BEHAVIORAL CENTER LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DAVID M BYNES LCSW (DIRECTOR)
(520) 323-9835
Entity
Organization
Contact information
Practice address
1122 N OLSEN AVE, TUCSON, AZ 85719-4717
(520) 323-9835
(520) 327-2342
Mailing address
5425 E BROADWAY BLVD, #315, TUCSON, AZ 85711-3704
(520) 323-9835
(520) 327-2342
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
LCSW-2746
AZ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
Z100597
MEDICARE IDENTIFIER
AZ
Enumeration date
04/01/2011
Last updated
04/01/2011
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