Provider Demographics
NPI:1235679929
Name:ALEE BEHAVIORAL HEALTHCARE
Entity Type:Organization
Organization Name:ALEE BEHAVIORAL HEALTHCARE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:REGIONAL DIRECTOR
Authorized Official - Prefix:MR
Authorized Official - First Name:PETER
Authorized Official - Middle Name:
Authorized Official - Last Name:ERKLAUER
Authorized Official - Suffix:
Authorized Official - Credentials:SLP MS,CCC
Authorized Official - Phone:401-270-9991
Mailing Address - Street 1:628 PARK AVE
Mailing Address - Street 2:SUITE 1D
Mailing Address - City:CRANSTON
Mailing Address - State:RI
Mailing Address - Zip Code:02910-2144
Mailing Address - Country:US
Mailing Address - Phone:401-270-9991
Mailing Address - Fax:401-270-2265
Practice Address - Street 1:628 PARK AVE
Practice Address - Street 2:SUITE 1D
Practice Address - City:CRANSTON
Practice Address - State:RI
Practice Address - Zip Code:02910-2144
Practice Address - Country:US
Practice Address - Phone:401-270-9991
Practice Address - Fax:401-270-2265
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-03-01
Last Update Date:2020-05-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
RILBA00075103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior AnalystGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
RI103K00000XOtherMENTAL HEALTH