Provider Demographics
NPI:1497262968
Name:BEHAVIOR LEARNING INTERVENTION STRATEGIES AND SOLUTIONS
Entity Type:Organization
Organization Name:BEHAVIOR LEARNING INTERVENTION STRATEGIES AND SOLUTIONS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:HOLLY
Authorized Official - Middle Name:
Authorized Official - Last Name:MASCELLI
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:818-599-6100
Mailing Address - Street 1:12920 CENTRAL AVE UNIT 204
Mailing Address - Street 2:
Mailing Address - City:HAWTHORNE
Mailing Address - State:CA
Mailing Address - Zip Code:90250-5888
Mailing Address - Country:US
Mailing Address - Phone:818-599-6100
Mailing Address - Fax:
Practice Address - Street 1:12920 CENTRAL AVE UNIT 204
Practice Address - Street 2:
Practice Address - City:HAWTHORNE
Practice Address - State:CA
Practice Address - Zip Code:90250-5888
Practice Address - Country:US
Practice Address - Phone:818-599-6100
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-01-05
Last Update Date:2018-01-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA1-11-8225103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior AnalystGroup - Single Specialty