Provider Demographics
NPI:1003975236
Name:LOVAAS INSTITUTE FOR EARLY INTERVENTION
Entity Type:Organization
Organization Name:LOVAAS INSTITUTE FOR EARLY INTERVENTION
Other - Org Name:LOVAAS INSTITUTE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CHIEF FINANCIAL OFFICER (CFO)
Authorized Official - Prefix:MR
Authorized Official - First Name:MATTHEW
Authorized Official - Middle Name:S
Authorized Official - Last Name:SANDS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:610-564-0912
Mailing Address - Street 1:5601 W SLAUSON AVE STE 266
Mailing Address - Street 2:
Mailing Address - City:CULVER CITY
Mailing Address - State:CA
Mailing Address - Zip Code:90230-6692
Mailing Address - Country:US
Mailing Address - Phone:310-410-4450
Mailing Address - Fax:310-410-4455
Practice Address - Street 1:5601 W SLAUSON AVE STE 266
Practice Address - Street 2:
Practice Address - City:CULVER CITY
Practice Address - State:CA
Practice Address - Zip Code:90230-6692
Practice Address - Country:US
Practice Address - Phone:310-410-4450
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-12-06
Last Update Date:2020-11-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL1-00-0252103K00000X
CA23924103TC0700X
CA4520103TM1800X
251S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior AnalystGroup - Single Specialty
No103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinicalGroup - Single Specialty
No103TM1800XBehavioral Health & Social Service ProvidersPsychologistIntellectual & Developmental DisabilitiesGroup - Single Specialty
No251S00000XAgenciesCommunity/Behavioral HealthGroup - Single Specialty