Provider Demographics
NPI:1104039122
Name:CENTER FOR LEARNING AND BEHAVIORAL SOLUTIONS, INC.
Entity Type:Organization
Organization Name:CENTER FOR LEARNING AND BEHAVIORAL SOLUTIONS, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CFO GENERAL MANAGER
Authorized Official - Prefix:MR
Authorized Official - First Name:HAMID
Authorized Official - Middle Name:
Authorized Official - Last Name:AFYOUNI
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:949-654-2424
Mailing Address - Street 1:16220 SCIENTIFIC WAY
Mailing Address - Street 2:
Mailing Address - City:IRVINE
Mailing Address - State:CA
Mailing Address - Zip Code:92618-4349
Mailing Address - Country:US
Mailing Address - Phone:949-654-2424
Mailing Address - Fax:949-654-2428
Practice Address - Street 1:16220 SCIENTIFIC WAY
Practice Address - Street 2:
Practice Address - City:IRVINE
Practice Address - State:CA
Practice Address - Zip Code:92618-4349
Practice Address - Country:US
Practice Address - Phone:949-654-2424
Practice Address - Fax:949-654-2428
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-07
Last Update Date:2012-06-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAPSY16441103TC0700X
CAPSY17893103TC0700X
CAPSY22848103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinicalGroup - Multi-Specialty