Provider Demographics
NPI:1598066516
Name:ILAN, INC
Entity Type:Organization
Organization Name:ILAN, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:MARIELA
Authorized Official - Middle Name:
Authorized Official - Last Name:VARGAS-IRWIN
Authorized Official - Suffix:
Authorized Official - Credentials:PSYD, BCBA-D
Authorized Official - Phone:781-619-1515
Mailing Address - Street 1:109 OAK ST STE G
Mailing Address - Street 2:
Mailing Address - City:NEWTON
Mailing Address - State:MA
Mailing Address - Zip Code:02464-1448
Mailing Address - Country:US
Mailing Address - Phone:781-619-1515
Mailing Address - Fax:781-619-1509
Practice Address - Street 1:109 OAK ST STE G
Practice Address - Street 2:
Practice Address - City:NEWTON
Practice Address - State:MA
Practice Address - Zip Code:02464-1448
Practice Address - Country:US
Practice Address - Phone:781-619-1515
Practice Address - Fax:781-619-1509
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-11-08
Last Update Date:2011-01-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior AnalystGroup - Multi-Specialty