Provider Demographics
NPI:1013219252
Name:BEHAVIORAL OUTREACH SERVICES, LLC
Entity Type:Organization
Organization Name:BEHAVIORAL OUTREACH SERVICES, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:SHILOH
Authorized Official - Middle Name:
Authorized Official - Last Name:BEENE
Authorized Official - Suffix:
Authorized Official - Credentials:MS, BCBA
Authorized Official - Phone:731-446-5441
Mailing Address - Street 1:142 MASON CEMETERY RD
Mailing Address - Street 2:
Mailing Address - City:HUMBOLDT
Mailing Address - State:TN
Mailing Address - Zip Code:38343
Mailing Address - Country:US
Mailing Address - Phone:731-446-5441
Mailing Address - Fax:731-784-2664
Practice Address - Street 1:142 MASON CEMETERY RD
Practice Address - Street 2:
Practice Address - City:HUMBOLDT
Practice Address - State:TN
Practice Address - Zip Code:38343
Practice Address - Country:US
Practice Address - Phone:731-446-5441
Practice Address - Fax:731-784-2664
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-11-19
Last Update Date:2012-10-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health