Provider Demographics
NPI:1104212885
Name:PERFORMANCE RESEARCH SCIENCES
Entity Type:Organization
Organization Name:PERFORMANCE RESEARCH SCIENCES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:SEAN
Authorized Official - Middle Name:
Authorized Official - Last Name:SOUTHLAND
Authorized Official - Suffix:
Authorized Official - Credentials:PHD
Authorized Official - Phone:480-278-6609
Mailing Address - Street 1:17470 N PACESETTER WAY
Mailing Address - Street 2:
Mailing Address - City:SCOTTSDALE
Mailing Address - State:AZ
Mailing Address - Zip Code:85255-5445
Mailing Address - Country:US
Mailing Address - Phone:480-278-6609
Mailing Address - Fax:
Practice Address - Street 1:17470 N PACESETTER WAY
Practice Address - Street 2:
Practice Address - City:SCOTTSDALE
Practice Address - State:AZ
Practice Address - Zip Code:85255-5445
Practice Address - Country:US
Practice Address - Phone:480-278-6609
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-04-09
Last Update Date:2015-04-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior AnalystGroup - Single Specialty