Provider Demographics
NPI:1629342746
Name:OPPORTUNITY BEHAVIORAL HEALTH
Entity Type:Organization
Organization Name:OPPORTUNITY BEHAVIORAL HEALTH
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT/FOUNDER
Authorized Official - Prefix:MR
Authorized Official - First Name:ROBERT
Authorized Official - Middle Name:H
Authorized Official - Last Name:CARVAJAL
Authorized Official - Suffix:
Authorized Official - Credentials:BCBA
Authorized Official - Phone:610-396-9900
Mailing Address - Street 1:543 ELM STREET
Mailing Address - Street 2:
Mailing Address - City:READING
Mailing Address - State:PA
Mailing Address - Zip Code:19601-3690
Mailing Address - Country:US
Mailing Address - Phone:610-396-9900
Mailing Address - Fax:610-396-9901
Practice Address - Street 1:543 ELM ST
Practice Address - Street 2:
Practice Address - City:READING
Practice Address - State:PA
Practice Address - Zip Code:19601-3386
Practice Address - Country:US
Practice Address - Phone:610-396-9900
Practice Address - Fax:610-396-9901
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-03-07
Last Update Date:2012-04-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD027300E251S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health