Provider Demographics
NPI:1932667987
Name:PRIME BEHAVIOR ANALYSIS, LLC
Entity Type:Organization
Organization Name:PRIME BEHAVIOR ANALYSIS, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PARTNER/DEPUTY DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:CHIH
Authorized Official - Middle Name:
Authorized Official - Last Name:YI
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:423-598-8776
Mailing Address - Street 1:670 LOCKHART RD
Mailing Address - Street 2:
Mailing Address - City:DUNLAP
Mailing Address - State:TN
Mailing Address - Zip Code:37327-3855
Mailing Address - Country:US
Mailing Address - Phone:423-598-8776
Mailing Address - Fax:
Practice Address - Street 1:670 LOCKHART RD
Practice Address - Street 2:
Practice Address - City:DUNLAP
Practice Address - State:TN
Practice Address - Zip Code:37327-3855
Practice Address - Country:US
Practice Address - Phone:423-598-8776
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-03-08
Last Update Date:2019-03-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior AnalystGroup - Single Specialty