Provider Demographics
NPI:1326691411
Name:FUNCTIONAL BEHAVIOR INTERVENTIONS
Entity Type:Organization
Organization Name:FUNCTIONAL BEHAVIOR INTERVENTIONS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MR
Authorized Official - First Name:CHARLES
Authorized Official - Middle Name:
Authorized Official - Last Name:KNOPPEL
Authorized Official - Suffix:
Authorized Official - Credentials:BCBA
Authorized Official - Phone:732-691-1299
Mailing Address - Street 1:2114 SANDRA RD
Mailing Address - Street 2:
Mailing Address - City:VOORHEES
Mailing Address - State:NJ
Mailing Address - Zip Code:08043-2069
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:2114 SANDRA RD
Practice Address - Street 2:
Practice Address - City:VOORHEES
Practice Address - State:NJ
Practice Address - Zip Code:08043-2069
Practice Address - Country:US
Practice Address - Phone:732-691-1299
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-07-18
Last Update Date:2019-07-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health