Provider Demographics
NPI:1932646478
Name:APPLIED BEHAVIORAL HEALTH CARE LLC
Entity Type:Organization
Organization Name:APPLIED BEHAVIORAL HEALTH CARE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:WILLIAM
Authorized Official - Middle Name:JOHN
Authorized Official - Last Name:RONAN
Authorized Official - Suffix:
Authorized Official - Credentials:LICSW
Authorized Official - Phone:952-933-3460
Mailing Address - Street 1:527 2ND ST NE
Mailing Address - Street 2:
Mailing Address - City:HOPKINS
Mailing Address - State:MN
Mailing Address - Zip Code:55343-3403
Mailing Address - Country:US
Mailing Address - Phone:952-933-3460
Mailing Address - Fax:953-938-5162
Practice Address - Street 1:527 2ND ST NE
Practice Address - Street 2:
Practice Address - City:HOPKINS
Practice Address - State:MN
Practice Address - Zip Code:55343-3403
Practice Address - Country:US
Practice Address - Phone:952-933-3460
Practice Address - Fax:952-938-5162
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-01-23
Last Update Date:2017-01-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN003711041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Multi-Specialty