Provider Demographics
NPI:1538705553
Name:ZAZRAK, INCORPORATED
Entity Type:Organization
Organization Name:ZAZRAK, INCORPORATED
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO/BCBA
Authorized Official - Prefix:MRS
Authorized Official - First Name:DESDALIN
Authorized Official - Middle Name:C
Authorized Official - Last Name:BLACK
Authorized Official - Suffix:
Authorized Official - Credentials:MS ED, BCBA,LABA
Authorized Official - Phone:419-633-0049
Mailing Address - Street 1:46 S. ASHBURNHAM ROAD
Mailing Address - Street 2:
Mailing Address - City:WESTMINSLER
Mailing Address - State:MA
Mailing Address - Zip Code:01473
Mailing Address - Country:US
Mailing Address - Phone:919-633-0049
Mailing Address - Fax:508-342-7542
Practice Address - Street 1:435 LEOMINSTER STREET SUITE 335
Practice Address - Street 2:
Practice Address - City:LEOMINSTER
Practice Address - State:MA
Practice Address - Zip Code:01453
Practice Address - Country:US
Practice Address - Phone:919-633-0049
Practice Address - Fax:508-342-7542
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-11-25
Last Update Date:2019-11-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior AnalystGroup - Multi-Specialty
No106S00000XBehavioral Health & Social Service ProvidersBehavior TechnicianGroup - Multi-Specialty