Provider Demographics
NPI:1922566538
Name:ENCOMPASS TELEBEHAVIORAL RESOURCES
Entity Type:Organization
Organization Name:ENCOMPASS TELEBEHAVIORAL RESOURCES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:ANNETTE
Authorized Official - Middle Name:DESIREE
Authorized Official - Last Name:GROEN
Authorized Official - Suffix:
Authorized Official - Credentials:PHD, BCBA
Authorized Official - Phone:303-249-2508
Mailing Address - Street 1:10671 TIMBERDASH AVE
Mailing Address - Street 2:
Mailing Address - City:HIGHLANDS RANCH
Mailing Address - State:CO
Mailing Address - Zip Code:80126-5733
Mailing Address - Country:US
Mailing Address - Phone:303-249-2508
Mailing Address - Fax:
Practice Address - Street 1:10671 TIMBERDASH AVE
Practice Address - Street 2:
Practice Address - City:HIGHLANDS RANCH
Practice Address - State:CO
Practice Address - Zip Code:80126-5733
Practice Address - Country:US
Practice Address - Phone:303-249-2508
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-03-04
Last Update Date:2019-03-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior AnalystGroup - Single Specialty