Provider Demographics
NPI:1578300034
Name:MANABAT LLC
Entity type:Organization
Organization Name:MANABAT LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:LEVIN
Authorized Official - Middle Name:E
Authorized Official - Last Name:MANABAT
Authorized Official - Suffix:
Authorized Official - Credentials:MSW, LCSW, LICSW
Authorized Official - Phone:971-381-8125
Mailing Address - Street 1:PO BOX 858
Mailing Address - Street 2:
Mailing Address - City:ESTACADA
Mailing Address - State:OR
Mailing Address - Zip Code:97023-0858
Mailing Address - Country:US
Mailing Address - Phone:971-381-8125
Mailing Address - Fax:971-600-9027
Practice Address - Street 1:40505 SE HIGHWAY 224 # 101
Practice Address - Street 2:
Practice Address - City:ESTACADA
Practice Address - State:OR
Practice Address - Zip Code:97023-9304
Practice Address - Country:US
Practice Address - Phone:971-381-8125
Practice Address - Fax:971-600-9027
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-07-11
Last Update Date:2025-01-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Multi-Specialty
No104100000XBehavioral Health & Social Service ProvidersSocial WorkerGroup - Multi-Specialty
No171M00000XOther Service ProvidersCase Manager/Care CoordinatorGroup - Multi-Specialty