Provider Demographics
NPI:1760848022
Name:CAPSHEAF BEHAVIORAL INSTITUTE, LLC
Entity Type:Organization
Organization Name:CAPSHEAF BEHAVIORAL INSTITUTE, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE DIRECTOR/CEO
Authorized Official - Prefix:MS
Authorized Official - First Name:AMESHA
Authorized Official - Middle Name:CORINE
Authorized Official - Last Name:SMITH
Authorized Official - Suffix:
Authorized Official - Credentials:BCBA
Authorized Official - Phone:888-557-1305
Mailing Address - Street 1:9126 QUINCY AVE
Mailing Address - Street 2:
Mailing Address - City:HESPERIA
Mailing Address - State:CA
Mailing Address - Zip Code:92345-6438
Mailing Address - Country:US
Mailing Address - Phone:888-557-1305
Mailing Address - Fax:888-557-1305
Practice Address - Street 1:9126 QUINCY AVE
Practice Address - Street 2:
Practice Address - City:HESPERIA
Practice Address - State:CA
Practice Address - Zip Code:92345-6438
Practice Address - Country:US
Practice Address - Phone:888-557-1305
Practice Address - Fax:888-557-1305
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-01-01
Last Update Date:2016-01-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior AnalystGroup - Multi-Specialty
No101Y00000XBehavioral Health & Social Service ProvidersCounselorGroup - Multi-Specialty