Provider Demographics
NPI:1669103933
Name:TX BEHAVIORAL SUPPORTS, LLC
Entity type:Organization
Organization Name:TX BEHAVIORAL SUPPORTS, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CO-OWNER/ANALYST
Authorized Official - Prefix:
Authorized Official - First Name:MCKINSIE
Authorized Official - Middle Name:
Authorized Official - Last Name:OBLAD
Authorized Official - Suffix:
Authorized Official - Credentials:MED, BCBA, LBA
Authorized Official - Phone:801-673-2839
Mailing Address - Street 1:5122 SKYLINE DR
Mailing Address - Street 2:
Mailing Address - City:FRISCO
Mailing Address - State:TX
Mailing Address - Zip Code:75036-8866
Mailing Address - Country:US
Mailing Address - Phone:801-673-2839
Mailing Address - Fax:
Practice Address - Street 1:5122 SKYLINE DR
Practice Address - Street 2:
Practice Address - City:FRISCO
Practice Address - State:TX
Practice Address - Zip Code:75036-8866
Practice Address - Country:US
Practice Address - Phone:210-857-8697
Practice Address - Fax:855-322-3694
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-06-18
Last Update Date:2022-06-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior AnalystGroup - Single Specialty
No106E00000XBehavioral Health & Social Service ProvidersAssistant Behavior AnalystGroup - Single Specialty
No106S00000XBehavioral Health & Social Service ProvidersBehavior TechnicianGroup - Single Specialty