Healthcare Provider Details

I. General information

NPI: 1770818080
Provider Name (Legal Business Name): BEHAVIOR AND EDUCATION INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/05/2009
Last Update Date: 06/27/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1444 AVIATION BLVD SUITE 103
REDONDO BEACH CA
90278-4001
US

IV. Provider business mailing address

1444 AVIATION BLVD SUITE 103
REDONDO BEACH CA
90278-4001
US

V. Phone/Fax

Practice location:
  • Phone: 310-406-1500
  • Fax: 310-406-1531
Mailing address:
  • Phone: 310-406-1500
  • Fax: 310-406-1531

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code252Y00000X
TaxonomyEarly Intervention Provider Agency
License Number
License Number StateNULL
# 2
Primary TaxonomyN
Taxonomy Code251S00000X
TaxonomyCommunity/Behavioral Health Agency
License Number
License Number StateNULL

VIII. Authorized Official

Name: BARBARA ENDLICH
Title or Position: PRESIDENT
Credential: MS, BCBA
Phone: 310-489-6717