Provider Demographics
NPI:1801554225
Name:DEVELOPMENTAL SPECIALTY PARTNERS
Entity type:Organization
Organization Name:DEVELOPMENTAL SPECIALTY PARTNERS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:BILAL
Authorized Official - Middle Name:
Authorized Official - Last Name:HAQ
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:513-305-3130
Mailing Address - Street 1:4251 S HIGUERA ST STE 800
Mailing Address - Street 2:
Mailing Address - City:SAN LUIS OBISPO
Mailing Address - State:CA
Mailing Address - Zip Code:93401-7736
Mailing Address - Country:US
Mailing Address - Phone:513-305-3130
Mailing Address - Fax:
Practice Address - Street 1:4251 S HIGUERA ST STE 800
Practice Address - Street 2:
Practice Address - City:SAN LUIS OBISPO
Practice Address - State:CA
Practice Address - Zip Code:93401-7736
Practice Address - Country:US
Practice Address - Phone:513-305-3130
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-12-02
Last Update Date:2021-12-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior AnalystGroup - Single Specialty