Provider Demographics
NPI:1134831092
Name:LASTING BEHAVIORAL SOLUTIONS LLC
Entity type:Organization
Organization Name:LASTING BEHAVIORAL SOLUTIONS LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:FOUNDER
Authorized Official - Prefix:
Authorized Official - First Name:NIRINA-SOA
Authorized Official - Middle Name:
Authorized Official - Last Name:ANDRIANIFAHANANA
Authorized Official - Suffix:
Authorized Official - Credentials:MS,BCBA
Authorized Official - Phone:571-490-1813
Mailing Address - Street 1:17203 PINTADO
Mailing Address - Street 2:
Mailing Address - City:IRVINE
Mailing Address - State:CA
Mailing Address - Zip Code:92618-0291
Mailing Address - Country:US
Mailing Address - Phone:571-490-1813
Mailing Address - Fax:
Practice Address - Street 1:17203 PINTADO
Practice Address - Street 2:
Practice Address - City:IRVINE
Practice Address - State:CA
Practice Address - Zip Code:92618-0291
Practice Address - Country:US
Practice Address - Phone:571-490-1813
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-12-21
Last Update Date:2022-12-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior AnalystGroup - Single Specialty