Provider Demographics
NPI:1740540418
Name:WISE BEHAVIORAL SERVICES, LLC
Entity type:Organization
Organization Name:WISE BEHAVIORAL SERVICES, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PROFESSIONAL CLINICAL COUNSELOR
Authorized Official - Prefix:MS
Authorized Official - First Name:CHRISTINE
Authorized Official - Middle Name:MARIE
Authorized Official - Last Name:SAYRE
Authorized Official - Suffix:
Authorized Official - Credentials:PCC
Authorized Official - Phone:330-605-8500
Mailing Address - Street 1:10533 PLANTERS COVE CIR NW
Mailing Address - Street 2:
Mailing Address - City:UNIONTOWN
Mailing Address - State:OH
Mailing Address - Zip Code:44685-6601
Mailing Address - Country:US
Mailing Address - Phone:330-305-0945
Mailing Address - Fax:330-305-0945
Practice Address - Street 1:10533 PLANTERS COVE CIR NW
Practice Address - Street 2:
Practice Address - City:UNIONTOWN
Practice Address - State:OH
Practice Address - Zip Code:44685-6601
Practice Address - Country:US
Practice Address - Phone:330-305-0945
Practice Address - Fax:330-305-0945
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-05-29
Last Update Date:2012-05-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251C00000XAgenciesDay Training, Developmentally Disabled Services