Provider Demographics
NPI:1972847564
Name:APPLIED BEHAVIORAL SERVICES DAYTON LLC
Entity Type:Organization
Organization Name:APPLIED BEHAVIORAL SERVICES DAYTON LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PROVIDER CREDENTIALING & PAYER CONT
Authorized Official - Prefix:
Authorized Official - First Name:DEENA
Authorized Official - Middle Name:STEIN
Authorized Official - Last Name:GREENBLATT
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:609-525-4271
Mailing Address - Street 1:2 VILLAGE SQ STE 2
Mailing Address - Street 2:
Mailing Address - City:BALTIMORE
Mailing Address - State:MD
Mailing Address - Zip Code:21210-1612
Mailing Address - Country:US
Mailing Address - Phone:609-525-4271
Mailing Address - Fax:937-847-8753
Practice Address - Street 1:2570 TECHNICAL DR
Practice Address - Street 2:
Practice Address - City:MIAMISBURG
Practice Address - State:OH
Practice Address - Zip Code:45342-6107
Practice Address - Country:US
Practice Address - Phone:937-847-8750
Practice Address - Fax:937-847-8753
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-11-20
Last Update Date:2024-03-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior AnalystGroup - Multi-Specialty
No225XP0200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistPediatricsGroup - Multi-Specialty
No235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language PathologistGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH0334817Medicaid