Provider Demographics
NPI:1245786003
Name:QUANTUM BEHAVIORAL CONSULTING, LLC
Entity Type:Organization
Organization Name:QUANTUM BEHAVIORAL CONSULTING, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR/SENIOR BEHAVIOR ANLAYST
Authorized Official - Prefix:MR
Authorized Official - First Name:SCOTT
Authorized Official - Middle Name:ALLYN
Authorized Official - Last Name:RODERICK
Authorized Official - Suffix:
Authorized Official - Credentials:BCBA
Authorized Official - Phone:860-338-3130
Mailing Address - Street 1:163 LEADMINE BROOK ROAD
Mailing Address - Street 2:
Mailing Address - City:HARWINTON
Mailing Address - State:CT
Mailing Address - Zip Code:06791
Mailing Address - Country:US
Mailing Address - Phone:860-338-3130
Mailing Address - Fax:
Practice Address - Street 1:163 LEAD MINE BROOK RD
Practice Address - Street 2:
Practice Address - City:HARWINTON
Practice Address - State:CT
Practice Address - Zip Code:06791-1315
Practice Address - Country:US
Practice Address - Phone:860-338-3130
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-08-31
Last Update Date:2016-11-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care