Provider Demographics
NPI:1477990083
Name:QBC, LLC
Entity Type:Organization
Organization Name:QBC, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:JONATHAN
Authorized Official - Middle Name:C
Authorized Official - Last Name:REDDING
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:814-777-3003
Mailing Address - Street 1:140 RHAUBERT CIR
Mailing Address - Street 2:
Mailing Address - City:STATE COLLEGE
Mailing Address - State:PA
Mailing Address - Zip Code:16801-7250
Mailing Address - Country:US
Mailing Address - Phone:814-777-3003
Mailing Address - Fax:
Practice Address - Street 1:140 RHAUBERT CIR
Practice Address - Street 2:
Practice Address - City:STATE COLLEGE
Practice Address - State:PA
Practice Address - Zip Code:16801-7250
Practice Address - Country:US
Practice Address - Phone:814-777-3003
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-05-23
Last Update Date:2013-05-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PABH000044103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior AnalystGroup - Single Specialty