Provider Demographics
NPI:1326480542
Name:SAGE BEHAVIOR SERVICES
Entity Type:Organization
Organization Name:SAGE BEHAVIOR SERVICES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SENIOR PROGRAM SUPERVISOR
Authorized Official - Prefix:MR
Authorized Official - First Name:STEVEN
Authorized Official - Middle Name:CHON
Authorized Official - Last Name:SCHLEICHER
Authorized Official - Suffix:
Authorized Official - Credentials:M ED
Authorized Official - Phone:714-425-2442
Mailing Address - Street 1:825 TAMARACK AVE
Mailing Address - Street 2:104
Mailing Address - City:BREA
Mailing Address - State:CA
Mailing Address - Zip Code:92821-2550
Mailing Address - Country:US
Mailing Address - Phone:714-425-2442
Mailing Address - Fax:
Practice Address - Street 1:1435 N HARBOR BLVD
Practice Address - Street 2:124
Practice Address - City:FULLERTON
Practice Address - State:CA
Practice Address - Zip Code:92835-4105
Practice Address - Country:US
Practice Address - Phone:714-425-2442
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-07-30
Last Update Date:2013-07-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health