Provider Demographics
NPI:1902227044
Name:APPLIED BEHAVIORAL INTERVENTIONS, LLC
Entity Type:Organization
Organization Name:APPLIED BEHAVIORAL INTERVENTIONS, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PROGRAM DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:JOSEPH
Authorized Official - Middle Name:
Authorized Official - Last Name:MITCHELL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:715-497-4416
Mailing Address - Street 1:219 N OAK PARK AVE
Mailing Address - Street 2:UNIT 1E
Mailing Address - City:OAK PARK
Mailing Address - State:IL
Mailing Address - Zip Code:60302-2151
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:219 N OAK PARK AVE
Practice Address - Street 2:UNIT 1E
Practice Address - City:OAK PARK
Practice Address - State:IL
Practice Address - Zip Code:60302-2151
Practice Address - Country:US
Practice Address - Phone:715-497-4416
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-12-16
Last Update Date:2013-12-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health