Healthcare Provider Details

I. General information

NPI: 1578060562
Provider Name (Legal Business Name): N.C. BEHAVIORAL SERVICES, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/07/2018
Last Update Date: 09/12/2025
Certification Date: 02/27/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1700 E FLORIDA AVE
HEMET CA
92544-4679
US

IV. Provider business mailing address

PO BOX 2686
HEMET CA
92546-2686
US

V. Phone/Fax

Practice location:
  • Phone: 951-357-6959
  • Fax: 951-356-2115
Mailing address:
  • Phone: 951-357-6959
  • Fax: 951-356-2115

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code106S00000X
TaxonomyBehavior Technician
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code103K00000X
TaxonomyBehavior Analyst
License Number1-14-9724
License Number StateCA

VIII. Authorized Official

Name: MRS. NACHOLE CALDWELL
Title or Position: CLINICAL DIRECTOR
Credential: BCBA
Phone: 951-297-9505