Provider Demographics
NPI:1811503014
Name:SOCIALIGHTS BEHAVIOR SERVICES LLC.
Entity type:Organization
Organization Name:SOCIALIGHTS BEHAVIOR SERVICES LLC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:ARIELLAH
Authorized Official - Middle Name:
Authorized Official - Last Name:HAYNES
Authorized Official - Suffix:
Authorized Official - Credentials:BCBA
Authorized Official - Phone:770-655-8733
Mailing Address - Street 1:308 RIPPLING DR
Mailing Address - Street 2:
Mailing Address - City:BALL GROUND
Mailing Address - State:GA
Mailing Address - Zip Code:30107-6024
Mailing Address - Country:US
Mailing Address - Phone:678-910-8781
Mailing Address - Fax:
Practice Address - Street 1:308 RIPPLING DR
Practice Address - Street 2:
Practice Address - City:BALL GROUND
Practice Address - State:GA
Practice Address - Zip Code:30107-6024
Practice Address - Country:US
Practice Address - Phone:678-910-8781
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-09-22
Last Update Date:2020-09-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior AnalystGroup - Single Specialty