Provider Demographics
NPI:1437538428
Name:YORK CENTER FOR CHILD DEVELOPMENT, LLC
Entity Type:Organization
Organization Name:YORK CENTER FOR CHILD DEVELOPMENT, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:BEHAVIOR ANALYST / SUPERVISOR
Authorized Official - Prefix:
Authorized Official - First Name:ELISA
Authorized Official - Middle Name:
Authorized Official - Last Name:HEGG
Authorized Official - Suffix:
Authorized Official - Credentials:BCBA
Authorized Official - Phone:617-448-1053
Mailing Address - Street 1:433 US RTE 1
Mailing Address - Street 2:COTTAGE PLACE, SUITE #109 F
Mailing Address - City:YORK
Mailing Address - State:ME
Mailing Address - Zip Code:03909-5154
Mailing Address - Country:US
Mailing Address - Phone:646-964-7268
Mailing Address - Fax:
Practice Address - Street 1:433 US ROUTE 1
Practice Address - Street 2:COTTAGE PLACE, SUITE #109 F
Practice Address - City:YORK
Practice Address - State:ME
Practice Address - Zip Code:03909-1659
Practice Address - Country:US
Practice Address - Phone:646-964-7268
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-05-22
Last Update Date:2015-11-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
1-04-2071103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior AnalystGroup - Single Specialty