Provider Demographics
NPI:1881036358
Name:FAMILY FIRST BEHAVIOR CONSULTANTS, INC
Entity Type:Organization
Organization Name:FAMILY FIRST BEHAVIOR CONSULTANTS, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:TRISTA
Authorized Official - Middle Name:
Authorized Official - Last Name:BODEN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:224-777-2063
Mailing Address - Street 1:213 WHITE OAK ST
Mailing Address - Street 2:
Mailing Address - City:HAMPSHIRE
Mailing Address - State:IL
Mailing Address - Zip Code:60140-4003
Mailing Address - Country:US
Mailing Address - Phone:224-777-2063
Mailing Address - Fax:
Practice Address - Street 1:213 WHITE OAK ST
Practice Address - Street 2:
Practice Address - City:HAMPSHIRE
Practice Address - State:IL
Practice Address - Zip Code:60140-4003
Practice Address - Country:US
Practice Address - Phone:224-777-2063
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-07-24
Last Update Date:2013-07-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior AnalystGroup - Single Specialty