Provider Demographics
NPI:1114436664
Name:POSITIVE BEHAVIOR INNOVATIONS, LLC
Entity Type:Organization
Organization Name:POSITIVE BEHAVIOR INNOVATIONS, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:MEGHANN
Authorized Official - Middle Name:K
Authorized Official - Last Name:KERNAN
Authorized Official - Suffix:
Authorized Official - Credentials:MED BCBA
Authorized Official - Phone:205-394-4337
Mailing Address - Street 1:607 26TH ST
Mailing Address - Street 2:
Mailing Address - City:TUSCALOOSA
Mailing Address - State:AL
Mailing Address - Zip Code:35401-5817
Mailing Address - Country:US
Mailing Address - Phone:205-394-4337
Mailing Address - Fax:
Practice Address - Street 1:815 27TH AVE
Practice Address - Street 2:
Practice Address - City:TUSCALOOSA
Practice Address - State:AL
Practice Address - Zip Code:35401-2119
Practice Address - Country:US
Practice Address - Phone:205-394-4337
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-09-28
Last Update Date:2017-09-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health