Provider Demographics
NPI:1083468672
Name:BEHAVIORAL ADVOCACY & SUPPORT, LLC
Entity Type:Organization
Organization Name:BEHAVIORAL ADVOCACY & SUPPORT, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:FOUNDER/OWNER
Authorized Official - Prefix:
Authorized Official - First Name:CANDACE
Authorized Official - Middle Name:
Authorized Official - Last Name:OSULLIVAN
Authorized Official - Suffix:
Authorized Official - Credentials:BCBA
Authorized Official - Phone:860-778-4514
Mailing Address - Street 1:23 HARNESS DR
Mailing Address - Street 2:
Mailing Address - City:SOUTHINGTON
Mailing Address - State:CT
Mailing Address - Zip Code:06489-1863
Mailing Address - Country:US
Mailing Address - Phone:860-778-4514
Mailing Address - Fax:
Practice Address - Street 1:23 HARNESS DR
Practice Address - Street 2:
Practice Address - City:SOUTHINGTON
Practice Address - State:CT
Practice Address - Zip Code:06489-1863
Practice Address - Country:US
Practice Address - Phone:860-778-4514
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-04-11
Last Update Date:2024-04-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health