Healthcare Provider Details

I. General information

NPI: 1265864276
Provider Name (Legal Business Name): STRATEGIC BEHAVIORAL SOLUTIONS LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/31/2013
Last Update Date: 07/28/2021
Certification Date: 07/28/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

390A SOUTHBRIDGE ST
AUBURN MA
01501-2456
US

IV. Provider business mailing address

390A SOUTHBRIDGE ST
AUBURN MA
01501-2456
US

V. Phone/Fax

Practice location:
  • Phone: 508-321-7141
  • Fax: 508-772-0050
Mailing address:
  • Phone: 508-321-7141
  • Fax: 508-772-0050

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103K00000X
TaxonomyBehavior Analyst
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code225X00000X
TaxonomyOccupational Therapist
License Number
License Number State

VIII. Authorized Official

Name: ERION KODRA
Title or Position: OWNER
Credential:
Phone: 508-955-0160