Provider Demographics
NPI:1225431513
Name:ADVANCED BEHAVIORAL SERVICES
Entity Type:Organization
Organization Name:ADVANCED BEHAVIORAL SERVICES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:BEHAVIOR ANALYST
Authorized Official - Prefix:MS
Authorized Official - First Name:LORITA
Authorized Official - Middle Name:LYNETTE
Authorized Official - Last Name:SLAUGHTER
Authorized Official - Suffix:
Authorized Official - Credentials:, MA, BCBA, LBA
Authorized Official - Phone:337-515-2994
Mailing Address - Street 1:352 HOFFPAUIR RD
Mailing Address - Street 2:
Mailing Address - City:RAGLEY
Mailing Address - State:LA
Mailing Address - Zip Code:70657-6233
Mailing Address - Country:US
Mailing Address - Phone:337-515-2994
Mailing Address - Fax:
Practice Address - Street 1:352 HOFFPAUIR RD
Practice Address - Street 2:
Practice Address - City:RAGLEY
Practice Address - State:LA
Practice Address - Zip Code:70657-6233
Practice Address - Country:US
Practice Address - Phone:337-515-2994
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-10-01
Last Update Date:2014-10-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LAL-033103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior AnalystGroup - Single Specialty