Provider Demographics
NPI:1356758338
Name:BEHAVIOR AND LEARNING SUPPORT
Entity type:Organization
Organization Name:BEHAVIOR AND LEARNING SUPPORT
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/DIRECTOR
Authorized Official - Prefix:MR
Authorized Official - First Name:REGIS
Authorized Official - Middle Name:
Authorized Official - Last Name:LAZOR
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:724-331-9499
Mailing Address - Street 1:390 LAKEWOOD RD
Mailing Address - Street 2:
Mailing Address - City:GREENSBURG
Mailing Address - State:PA
Mailing Address - Zip Code:15601-9769
Mailing Address - Country:US
Mailing Address - Phone:724-331-9499
Mailing Address - Fax:412-405-8567
Practice Address - Street 1:390 LAKEWOOD RD
Practice Address - Street 2:
Practice Address - City:GREENSBURG
Practice Address - State:PA
Practice Address - Zip Code:15601-9769
Practice Address - Country:US
Practice Address - Phone:724-331-9499
Practice Address - Fax:412-405-8567
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-07-22
Last Update Date:2014-07-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior AnalystGroup - Single Specialty
No251S00000XAgenciesCommunity/Behavioral HealthGroup - Single Specialty