Provider Demographics
NPI:1396958377
Name:BEHAVIORAL RESEARCH ASSOCIATES
Entity type:Organization
Organization Name:BEHAVIORAL RESEARCH ASSOCIATES
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE ASSISTANT/ACCOUNTANT
Authorized Official - Prefix:MS
Authorized Official - First Name:ANNETTE
Authorized Official - Middle Name:
Authorized Official - Last Name:HOUSE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:202-391-4028
Mailing Address - Street 1:PO BOX 492110
Mailing Address - Street 2:
Mailing Address - City:FORT WASHINGTON
Mailing Address - State:MD
Mailing Address - Zip Code:20749
Mailing Address - Country:US
Mailing Address - Phone:301-203-1942
Mailing Address - Fax:
Practice Address - Street 1:12201 HOLLY BANK DRIVE
Practice Address - Street 2:
Practice Address - City:FT. WASHINGTON
Practice Address - State:MD
Practice Address - Zip Code:20744
Practice Address - Country:US
Practice Address - Phone:301-203-1942
Practice Address - Fax:301-203-4522
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-07
Last Update Date:2021-12-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes315P00000XNursing & Custodial Care FacilitiesIntermediate Care Facility, Intellectual Disabilities
No261QD1600XAmbulatory Health Care FacilitiesClinic/CenterDevelopmental Disabilities
Provider Identifiers
StateIdentifier IDID TypeIssuer
DC024474400Medicaid
DC024475200Medicaid
DC024476900Medicaid
DC038771800Medicaid
DC024473600Medicaid