Healthcare Provider Details
I. General information
NPI: 1972841765
Provider Name (Legal Business Name): APPLIED BEHAVIOR & LEARNING ENTERPRISES
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 01/29/2013
Last Update Date: 01/29/2013
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
7120 HAYVENHURST AVE SUITE 401
VAN NUYS CA
91406-3843
US
IV. Provider business mailing address
7120 HAYVENHURST AVE SUITE 401
VAN NUYS CA
91406-3843
US
V. Phone/Fax
- Phone: 818-909-2253
- Fax:
- Phone: 818-909-2253
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 103K00000X |
| Taxonomy | Behavior Analyst |
| License Number | |
| License Number State | |
| # 2 | |
| Primary Taxonomy | N |
| Taxonomy Code | 251S00000X |
| Taxonomy | Community/Behavioral Health Agency |
| License Number | |
| License Number State | |
| # 3 | |
| Primary Taxonomy | N |
| Taxonomy Code | 385HR2065X |
| Taxonomy | Child Physical Disabilities Respite Care |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
LEAH
JIMENEZ
Title or Position: DIRECTOR OF OPERATIONS/OWNER
Credential:
Phone: 818-909-2253