Provider Demographics
NPI:1114289030
Name:GROWTH AND DEVELOPMENT BEHAVIORAL MANAGEMENT INC.
Entity Type:Organization
Organization Name:GROWTH AND DEVELOPMENT BEHAVIORAL MANAGEMENT INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MS
Authorized Official - First Name:KAREN
Authorized Official - Middle Name:
Authorized Official - Last Name:SACHS
Authorized Official - Suffix:
Authorized Official - Credentials:MSED
Authorized Official - Phone:631-391-0198
Mailing Address - Street 1:86 SCHLEIGEL BLVD
Mailing Address - Street 2:
Mailing Address - City:FARMINGDALE
Mailing Address - State:NY
Mailing Address - Zip Code:11735-6256
Mailing Address - Country:US
Mailing Address - Phone:632-391-0198
Mailing Address - Fax:
Practice Address - Street 1:86 SCHLEIGEL BLVD
Practice Address - Street 2:
Practice Address - City:FARMINGDALE
Practice Address - State:NY
Practice Address - Zip Code:11735-6256
Practice Address - Country:US
Practice Address - Phone:631-391-0198
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-06-15
Last Update Date:2012-08-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Single Specialty