Provider Demographics
NPI:1104203223
Name:BEHAVIORAL AND CULTURAL DEVELOPMENT SOLUTIONS
Entity Type:Organization
Organization Name:BEHAVIORAL AND CULTURAL DEVELOPMENT SOLUTIONS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:CAREY
Authorized Official - Middle Name:WINSTON
Authorized Official - Last Name:BAILEY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:610-664-1506
Mailing Address - Street 1:150 MONUMENT RD
Mailing Address - Street 2:SUITE 207
Mailing Address - City:BALA CYNWYD
Mailing Address - State:PA
Mailing Address - Zip Code:19004-1702
Mailing Address - Country:US
Mailing Address - Phone:610-664-1506
Mailing Address - Fax:610-664-1508
Practice Address - Street 1:150 MONUMENT RD
Practice Address - Street 2:SUITE 207
Practice Address - City:BALA CYNWYD
Practice Address - State:PA
Practice Address - Zip Code:19004-1702
Practice Address - Country:US
Practice Address - Phone:610-664-1506
Practice Address - Fax:610-664-1508
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-04-27
Last Update Date:2015-05-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
101YM0800X
PABH001283103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior AnalystGroup - Multi-Specialty
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA1467865766Medicaid
PA1467865766Medicare PIN