Provider Demographics
NPI:1750125902
Name:BEHAVIORCARE HUB LLC
Entity type:Organization
Organization Name:BEHAVIORCARE HUB LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/CEO
Authorized Official - Prefix:
Authorized Official - First Name:CHELSEA
Authorized Official - Middle Name:B
Authorized Official - Last Name:ANSONG
Authorized Official - Suffix:
Authorized Official - Credentials:BCBA
Authorized Official - Phone:917-946-5179
Mailing Address - Street 1:5 NANDINA CT
Mailing Address - Street 2:
Mailing Address - City:BOLINGBROOK
Mailing Address - State:IL
Mailing Address - Zip Code:60490-2121
Mailing Address - Country:US
Mailing Address - Phone:917-946-5179
Mailing Address - Fax:
Practice Address - Street 1:5 NANDINA CT
Practice Address - Street 2:
Practice Address - City:BOLINGBROOK
Practice Address - State:IL
Practice Address - Zip Code:60490-2121
Practice Address - Country:US
Practice Address - Phone:917-946-5179
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-06-22
Last Update Date:2024-06-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior AnalystGroup - Multi-Specialty