Provider Demographics
NPI:1578348900
Name:GREAT STRIDES BEHAVIOR SOLUTIONS, LLC
Entity Type:Organization
Organization Name:GREAT STRIDES BEHAVIOR SOLUTIONS, LLC
Other - Org Name:GREAT STRIDES BEHAVIOR SOLUTIONS, LLC
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CLINICAL DIRECTOR/OWNER
Authorized Official - Prefix:
Authorized Official - First Name:ERIN
Authorized Official - Middle Name:MALLORY
Authorized Official - Last Name:COLLINS
Authorized Official - Suffix:
Authorized Official - Credentials:BCBA, LBA-TN
Authorized Official - Phone:901-864-7318
Mailing Address - Street 1:7410 APPLING MIST DR
Mailing Address - Street 2:
Mailing Address - City:CORDOVA
Mailing Address - State:TN
Mailing Address - Zip Code:38016-4980
Mailing Address - Country:US
Mailing Address - Phone:901-430-9675
Mailing Address - Fax:901-545-2734
Practice Address - Street 1:7410 APPLING MIST DR
Practice Address - Street 2:
Practice Address - City:CORDOVA
Practice Address - State:TN
Practice Address - Zip Code:38016-4980
Practice Address - Country:US
Practice Address - Phone:252-381-0632
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-08-24
Last Update Date:2023-09-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior AnalystGroup - Multi-Specialty