Healthcare Provider Details

I. General information

NPI: 1760074702
Provider Name (Legal Business Name): M2N INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/10/2021
Last Update Date: 02/10/2021
Certification Date: 02/10/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

127 S BRAND BLVD STE 228
GLENDALE CA
91204-1374
US

IV. Provider business mailing address

127 S BRAND BLVD STE 228
GLENDALE CA
91204-1374
US

V. Phone/Fax

Practice location:
  • Phone: 747-215-9143
  • Fax: 747-279-4497
Mailing address:
  • Phone: 818-926-1005
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103K00000X
TaxonomyBehavior Analyst
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code106E00000X
TaxonomyAssistant Behavior Analyst
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code106S00000X
TaxonomyBehavior Technician
License Number
License Number State
# 4
Primary TaxonomyN
Taxonomy Code251S00000X
TaxonomyCommunity/Behavioral Health Agency
License Number
License Number State
# 5
Primary TaxonomyN
Taxonomy Code252Y00000X
TaxonomyEarly Intervention Provider Agency
License Number
License Number State
# 6
Primary TaxonomyN
Taxonomy Code373H00000X
TaxonomyDay Training/Habilitation Specialist
License Number
License Number State

VIII. Authorized Official

Name: NANOOR SHAHIN
Title or Position: CLINICAL DIRECTOR/ VICE PRESIDENT
Credential: M.A., BCBA
Phone: 818-926-1005