Provider Demographics
NPI:1881779973
Name:BEHAVIORAL TECHNOLOGIES, CORP
Entity type:Organization
Organization Name:BEHAVIORAL TECHNOLOGIES, CORP
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MR
Authorized Official - First Name:DAVID
Authorized Official - Middle Name:EDWARD
Authorized Official - Last Name:BRADISH
Authorized Official - Suffix:JR
Authorized Official - Credentials:
Authorized Official - Phone:515-263-9109
Mailing Address - Street 1:2601 E UNIVERSITY AVE
Mailing Address - Street 2:
Mailing Address - City:DES MOINES
Mailing Address - State:IA
Mailing Address - Zip Code:50317-5323
Mailing Address - Country:US
Mailing Address - Phone:515-263-9109
Mailing Address - Fax:
Practice Address - Street 1:2601 E UNIVERSITY AVE
Practice Address - Street 2:
Practice Address - City:DES MOINES
Practice Address - State:IA
Practice Address - Zip Code:50317-5323
Practice Address - Country:US
Practice Address - Phone:515-263-9109
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-26
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA0132761315P00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes315P00000XNursing & Custodial Care FacilitiesIntermediate Care Facility, Intellectual Disabilities