Provider Demographics
NPI:1588203822
Name:NATURALISTIC LEARNING CENTER LLC
Entity Type:Organization
Organization Name:NATURALISTIC LEARNING CENTER LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CO-OWNER/ BCBA
Authorized Official - Prefix:
Authorized Official - First Name:LAUREN
Authorized Official - Middle Name:
Authorized Official - Last Name:SHANLEY
Authorized Official - Suffix:
Authorized Official - Credentials:BCBA, LBA
Authorized Official - Phone:203-917-6185
Mailing Address - Street 1:PO BOX 139
Mailing Address - Street 2:
Mailing Address - City:REDDING
Mailing Address - State:CT
Mailing Address - Zip Code:06896-0139
Mailing Address - Country:US
Mailing Address - Phone:475-204-6410
Mailing Address - Fax:203-826-2326
Practice Address - Street 1:215 BRUSHY HILL RD
Practice Address - Street 2:
Practice Address - City:DANBURY
Practice Address - State:CT
Practice Address - Zip Code:06810-8430
Practice Address - Country:US
Practice Address - Phone:475-204-6410
Practice Address - Fax:203-826-2326
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-01-03
Last Update Date:2020-01-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior AnalystGroup - Single Specialty