Provider Demographics
NPI:1396496212
Name:KLUN BEHAVIORAL CARE LLC
Entity type:Organization
Organization Name:KLUN BEHAVIORAL CARE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER / CLINICIAN
Authorized Official - Prefix:MR
Authorized Official - First Name:DAVID
Authorized Official - Middle Name:W
Authorized Official - Last Name:KLUN
Authorized Official - Suffix:JR
Authorized Official - Credentials:LMHC
Authorized Official - Phone:617-863-0510
Mailing Address - Street 1:316 SEA ST APT A
Mailing Address - Street 2:
Mailing Address - City:HYANNIS
Mailing Address - State:MA
Mailing Address - Zip Code:02601-4565
Mailing Address - Country:US
Mailing Address - Phone:617-863-0510
Mailing Address - Fax:
Practice Address - Street 1:21 PINE ST UNIT F
Practice Address - Street 2:
Practice Address - City:CANTON
Practice Address - State:MA
Practice Address - Zip Code:02021-3356
Practice Address - Country:US
Practice Address - Phone:617-863-0510
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-01-12
Last Update Date:2022-01-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0850XAmbulatory Health Care FacilitiesClinic/CenterAdult Mental Health