Provider Demographics
NPI:1821618075
Name:PHASE ONE BEHAVIORAL SOLUTIONS, LLC
Entity Type:Organization
Organization Name:PHASE ONE BEHAVIORAL SOLUTIONS, LLC
Other - Org Name:PHASE ONE SOLUTIONS, LLC
Other - Org Type:Former Legal Business Name
Authorized Official - Title/Position:BCBA, LABA, OWENER
Authorized Official - Prefix:
Authorized Official - First Name:KRISTEN
Authorized Official - Middle Name:
Authorized Official - Last Name:BIANCHI
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:774-230-1934
Mailing Address - Street 1:10304 ARBOR DR
Mailing Address - Street 2:
Mailing Address - City:SHREWSBURY
Mailing Address - State:MA
Mailing Address - Zip Code:01545-6042
Mailing Address - Country:US
Mailing Address - Phone:774-230-1934
Mailing Address - Fax:
Practice Address - Street 1:10304 ARBOR DR
Practice Address - Street 2:
Practice Address - City:SHREWSBURY
Practice Address - State:MA
Practice Address - Zip Code:01545-6042
Practice Address - Country:US
Practice Address - Phone:774-230-1934
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-04-17
Last Update Date:2021-01-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior AnalystGroup - Single Specialty