Healthcare Provider Details
I. General information
NPI: 1811542467
Provider Name (Legal Business Name): FLEX LEARNING, LLC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 08/09/2019
Last Update Date: 08/15/2019
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
145 W BROADWAY
LONG BEACH CA
90802-4413
US
IV. Provider business mailing address
1720 E 2ND ST APT 12
LONG BEACH CA
90802-8409
US
V. Phone/Fax
- Phone: 562-661-8900
- Fax:
- Phone: 951-255-6438
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 103K00000X |
| Taxonomy | Behavior Analyst |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name: MR.
MIGUEL
ANTONIO
FLORES
Title or Position: CLINICAL EXECUTIVE DIRECTOR
Credential: BCBA
Phone: 562-661-8900