Provider Demographics
NPI:1366671232
Name:BEHAVIOR SERVICES MANAGEMENT
Entity Type:Organization
Organization Name:BEHAVIOR SERVICES MANAGEMENT
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT / CEO
Authorized Official - Prefix:MR
Authorized Official - First Name:MATTHEW
Authorized Official - Middle Name:ANTHONY
Authorized Official - Last Name:MANNING
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:252-985-3009
Mailing Address - Street 1:120 N FRANKLIN ST STE E
Mailing Address - Street 2:
Mailing Address - City:ROCKY MOUNT
Mailing Address - State:NC
Mailing Address - Zip Code:27804-5448
Mailing Address - Country:US
Mailing Address - Phone:252-985-3009
Mailing Address - Fax:252-985-2004
Practice Address - Street 1:120 N FRANKLIN ST STE E
Practice Address - Street 2:
Practice Address - City:ROCKY MOUNT
Practice Address - State:NC
Practice Address - Zip Code:27804-5448
Practice Address - Country:US
Practice Address - Phone:252-985-3009
Practice Address - Fax:252-985-2004
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-07-13
Last Update Date:2009-07-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes305R00000XManaged Care OrganizationsPreferred Provider Organization