Provider Demographics
NPI:1275123143
Name:BEHAVIOR SUPPORTS AND SOLUTIONS LLC
Entity Type:Organization
Organization Name:BEHAVIOR SUPPORTS AND SOLUTIONS LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:RICHARD
Authorized Official - Middle Name:JOSE
Authorized Official - Last Name:ROBLES
Authorized Official - Suffix:
Authorized Official - Credentials:BCBA, LBA
Authorized Official - Phone:510-305-9391
Mailing Address - Street 1:122 STERN CT
Mailing Address - Street 2:
Mailing Address - City:TOOELE
Mailing Address - State:UT
Mailing Address - Zip Code:84074-8012
Mailing Address - Country:US
Mailing Address - Phone:510-305-9391
Mailing Address - Fax:
Practice Address - Street 1:122 STERN CT
Practice Address - Street 2:
Practice Address - City:TOOELE
Practice Address - State:UT
Practice Address - Zip Code:84074-8012
Practice Address - Country:US
Practice Address - Phone:510-305-9391
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-01-24
Last Update Date:2021-01-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior AnalystGroup - Single Specialty