Provider Demographics
NPI:1013580026
Name:HART BEHAVIOR LLC
Entity Type:Organization
Organization Name:HART BEHAVIOR LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:BCBA
Authorized Official - Prefix:
Authorized Official - First Name:KRISTINA
Authorized Official - Middle Name:
Authorized Official - Last Name:HARTSELL
Authorized Official - Suffix:
Authorized Official - Credentials:BCBA
Authorized Official - Phone:219-476-5809
Mailing Address - Street 1:731 W MARREW PL
Mailing Address - Street 2:
Mailing Address - City:VALPARAISO
Mailing Address - State:IN
Mailing Address - Zip Code:46383-4089
Mailing Address - Country:US
Mailing Address - Phone:219-476-5809
Mailing Address - Fax:
Practice Address - Street 1:731 W MARREW PL
Practice Address - Street 2:
Practice Address - City:VALPARAISO
Practice Address - State:IN
Practice Address - Zip Code:46383-4089
Practice Address - Country:US
Practice Address - Phone:219-476-5809
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-07-19
Last Update Date:2021-07-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior AnalystGroup - Single Specialty