Provider Demographics
NPI:1831848720
Name:LENOX CHILD DEVELOPMENT CENTER
Entity type:Organization
Organization Name:LENOX CHILD DEVELOPMENT CENTER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MS
Authorized Official - First Name:OKSANA
Authorized Official - Middle Name:
Authorized Official - Last Name:BELOVA
Authorized Official - Suffix:
Authorized Official - Credentials:BCBA
Authorized Official - Phone:678-250-3225
Mailing Address - Street 1:8626 OVATION DR
Mailing Address - Street 2:
Mailing Address - City:CARY
Mailing Address - State:NC
Mailing Address - Zip Code:27513-2648
Mailing Address - Country:US
Mailing Address - Phone:305-570-6117
Mailing Address - Fax:
Practice Address - Street 1:690 PIEDMONT AVE NE APT 19
Practice Address - Street 2:
Practice Address - City:ATLANTA
Practice Address - State:GA
Practice Address - Zip Code:30308-1956
Practice Address - Country:US
Practice Address - Phone:678-250-3225
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-03-20
Last Update Date:2022-03-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior AnalystGroup - Multi-Specialty