Healthcare Provider Details

I. General information

NPI: 1962838409
Provider Name (Legal Business Name): RED HOUSE BEHAVIOR RESOURCES, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/16/2013
Last Update Date: 09/17/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

268 BUSH ST #3039
SAN FRANCISCO CA
94104-3503
US

IV. Provider business mailing address

268 BUSH ST #3039
SAN FRANCISCO CA
94104-3503
US

V. Phone/Fax

Practice location:
  • Phone: 888-362-3970
  • Fax: 508-882-7687
Mailing address:
  • Phone: 888-362-3970
  • Fax: 508-882-7687

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103K00000X
TaxonomyBehavior Analyst
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code103T00000X
TaxonomyPsychologist
License Number
License Number State

VIII. Authorized Official

Name: DR. ROBERT LEVINE
Title or Position: PRESIDENT
Credential: PH.D., BCBA-D
Phone: 888-362-3970