Provider Demographics
NPI:1821434069
Name:BEHAVIORAL EDUCATION FOR CHILDREN WITH AUTISM
Entity Type:Organization
Organization Name:BEHAVIORAL EDUCATION FOR CHILDREN WITH AUTISM
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:GREGORY
Authorized Official - Middle Name:MARTIN
Authorized Official - Last Name:ELSKY
Authorized Official - Suffix:
Authorized Official - Credentials:PSYD, MFT
Authorized Official - Phone:310-787-9334
Mailing Address - Street 1:369 VAN NESS WAY
Mailing Address - Street 2:SUITE 710
Mailing Address - City:TORRANCE
Mailing Address - State:CA
Mailing Address - Zip Code:90501-1489
Mailing Address - Country:US
Mailing Address - Phone:310-787-9334
Mailing Address - Fax:310-787-8626
Practice Address - Street 1:369 VAN NESS WAY
Practice Address - Street 2:SUITE 710
Practice Address - City:TORRANCE
Practice Address - State:CA
Practice Address - Zip Code:90501-1489
Practice Address - Country:US
Practice Address - Phone:310-787-9334
Practice Address - Fax:310-787-8626
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-05-15
Last Update Date:2013-05-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA1-08-4884103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior AnalystGroup - Single Specialty