Provider Demographics
NPI:1336556661
Name:BEHAVIORWORKS LLC
Entity Type:Organization
Organization Name:BEHAVIORWORKS LLC
Other - Org Name:BEHAVIORWORKS ABA
Other - Org Type:Doing Business As
Authorized Official - Title/Position:FOUNDER & PRESIDENT
Authorized Official - Prefix:MRS
Authorized Official - First Name:ANN
Authorized Official - Middle Name:M
Authorized Official - Last Name:BALOSKI
Authorized Official - Suffix:
Authorized Official - Credentials:MA, BCBA
Authorized Official - Phone:317-691-4973
Mailing Address - Street 1:618 N HIGH SCHOOL RD STE A
Mailing Address - Street 2:
Mailing Address - City:INDIANAPOLIS
Mailing Address - State:IN
Mailing Address - Zip Code:46214-3684
Mailing Address - Country:US
Mailing Address - Phone:317-837-4955
Mailing Address - Fax:317-837-4901
Practice Address - Street 1:618 N HIGH SCHOOL RD STE A
Practice Address - Street 2:
Practice Address - City:INDIANAPOLIS
Practice Address - State:IN
Practice Address - Zip Code:46214-3684
Practice Address - Country:US
Practice Address - Phone:317-837-4955
Practice Address - Fax:317-942-0863
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-07-18
Last Update Date:2016-10-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes252Y00000XAgenciesEarly Intervention Provider Agency
No251S00000XAgenciesCommunity/Behavioral Health