Provider Demographics
NPI:1851141667
Name:INNOVATIVE BEHAVIOR SOLUTIONS LLC
Entity Type:Organization
Organization Name:INNOVATIVE BEHAVIOR SOLUTIONS LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MS
Authorized Official - First Name:NEIVEIN
Authorized Official - Middle Name:
Authorized Official - Last Name:MAHMOUD
Authorized Official - Suffix:
Authorized Official - Credentials:BCBA
Authorized Official - Phone:732-200-4271
Mailing Address - Street 1:1103 LAKEWOOD RD
Mailing Address - Street 2:
Mailing Address - City:TOMS RIVER
Mailing Address - State:NJ
Mailing Address - Zip Code:08753-4111
Mailing Address - Country:US
Mailing Address - Phone:732-200-4271
Mailing Address - Fax:732-608-6871
Practice Address - Street 1:1103 LAKEWOOD RD
Practice Address - Street 2:
Practice Address - City:TOMS RIVER
Practice Address - State:NJ
Practice Address - Zip Code:08753-4111
Practice Address - Country:US
Practice Address - Phone:732-200-4271
Practice Address - Fax:732-608-6871
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-03-25
Last Update Date:2024-03-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior AnalystGroup - Single Specialty