Provider Demographics
NPI:1235460411
Name:BEHAVIOR EDUCATION AND RESOURCE SPECIALISTS INC
Entity Type:Organization
Organization Name:BEHAVIOR EDUCATION AND RESOURCE SPECIALISTS INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:FINANCE
Authorized Official - Prefix:
Authorized Official - First Name:SANDI
Authorized Official - Middle Name:
Authorized Official - Last Name:BENNETT
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:252-537-8802
Mailing Address - Street 1:1609 E 10TH ST
Mailing Address - Street 2:
Mailing Address - City:ROANOKE RAPIDS
Mailing Address - State:NC
Mailing Address - Zip Code:27870-4103
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:1609 E 10TH ST
Practice Address - Street 2:
Practice Address - City:ROANOKE RAPIDS
Practice Address - State:NC
Practice Address - Zip Code:27870-4103
Practice Address - Country:US
Practice Address - Phone:252-537-6799
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-01-27
Last Update Date:2010-01-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC8300824BOtherBLUE CROSS BLUE SHIELD
NC8300824BOtherHEALTH CHOICE
NC8300824BMedicaid