Provider Demographics
NPI:1821413584
Name:QUANTUM BEHAVIORAL SOLUTIONS, INC
Entity Type:Organization
Organization Name:QUANTUM BEHAVIORAL SOLUTIONS, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CLINICAL DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:ANN
Authorized Official - Middle Name:
Authorized Official - Last Name:KIM
Authorized Official - Suffix:
Authorized Official - Credentials:MS,BCBA
Authorized Official - Phone:626-531-6999
Mailing Address - Street 1:1740 HUNTINGTON DR STE 305
Mailing Address - Street 2:
Mailing Address - City:DUARTE
Mailing Address - State:CA
Mailing Address - Zip Code:91010-3842
Mailing Address - Country:US
Mailing Address - Phone:626-531-6999
Mailing Address - Fax:626-531-6998
Practice Address - Street 1:1740 HUNTINGTON DR STE 305
Practice Address - Street 2:
Practice Address - City:DUARTE
Practice Address - State:CA
Practice Address - Zip Code:91010-3842
Practice Address - Country:US
Practice Address - Phone:626-531-6999
Practice Address - Fax:626-531-6998
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-03-04
Last Update Date:2014-03-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA11314196103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior AnalystGroup - Multi-Specialty