Provider Demographics
NPI:1689176935
Name:THE LOVAAS CENTER FOR BEHAVIOR INTERVENTION
Entity Type:Organization
Organization Name:THE LOVAAS CENTER FOR BEHAVIOR INTERVENTION
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SUPERVISING CONSULTANT
Authorized Official - Prefix:
Authorized Official - First Name:LENISE
Authorized Official - Middle Name:
Authorized Official - Last Name:KRYK
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:702-877-2521
Mailing Address - Street 1:5550 W FLAMINGO RD STE C5
Mailing Address - Street 2:
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89103-0137
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:5550 W FLAMINGO RD STE C5
Practice Address - Street 2:
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89103-0137
Practice Address - Country:US
Practice Address - Phone:702-877-2520
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-03-02
Last Update Date:2018-03-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261Q00000XAmbulatory Health Care FacilitiesClinic/Center