Provider Demographics
NPI:1639680481
Name:KEY ESSENTIALS TO BEHAVIOR MANAGEMENT, CORP
Entity Type:Organization
Organization Name:KEY ESSENTIALS TO BEHAVIOR MANAGEMENT, CORP
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:LAKEYSHA
Authorized Official - Middle Name:L
Authorized Official - Last Name:COBBS-HAYES
Authorized Official - Suffix:
Authorized Official - Credentials:BCBA
Authorized Official - Phone:909-304-1353
Mailing Address - Street 1:9333 BASELINE RD STE 290
Mailing Address - Street 2:
Mailing Address - City:RANCHO CUCAMONGA
Mailing Address - State:CA
Mailing Address - Zip Code:91730-1300
Mailing Address - Country:US
Mailing Address - Phone:909-320-8300
Mailing Address - Fax:951-346-3640
Practice Address - Street 1:9333 BASELINE RD STE 290
Practice Address - Street 2:
Practice Address - City:RANCHO CUCAMONGA
Practice Address - State:CA
Practice Address - Zip Code:91730-1300
Practice Address - Country:US
Practice Address - Phone:909-320-8300
Practice Address - Fax:951-346-3640
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-10-19
Last Update Date:2021-11-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA1-16-23436103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior AnalystGroup - Single Specialty