Provider Demographics
NPI:1164179206
Name:JOYFUL BEHAVIOR ANALYTIC SERVICES
Entity Type:Organization
Organization Name:JOYFUL BEHAVIOR ANALYTIC SERVICES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT, FOUNDER
Authorized Official - Prefix:
Authorized Official - First Name:CHRYSTLE
Authorized Official - Middle Name:
Authorized Official - Last Name:MEDINA
Authorized Official - Suffix:
Authorized Official - Credentials:BCBA, LBA
Authorized Official - Phone:661-478-9586
Mailing Address - Street 1:2636 N SALISBURY BLVD # 1032
Mailing Address - Street 2:
Mailing Address - City:SALISBURY
Mailing Address - State:MD
Mailing Address - Zip Code:21801-2141
Mailing Address - Country:US
Mailing Address - Phone:661-478-9586
Mailing Address - Fax:
Practice Address - Street 1:100 N DIVISION ST # 2A
Practice Address - Street 2:
Practice Address - City:SALISBURY
Practice Address - State:MD
Practice Address - Zip Code:21801-5039
Practice Address - Country:US
Practice Address - Phone:661-478-9586
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-03-08
Last Update Date:2023-01-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health