Healthcare Provider Details

I. General information

NPI: 1699272948
Provider Name (Legal Business Name): APPLIED BEHAVIORAL SCIENCE INSTITUTION LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/11/2018
Last Update Date: 08/29/2025
Certification Date: 08/29/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4893 EAST BELTLINE AVE NE SUITE 310
GRAND RAPIDS MI
49525
US

IV. Provider business mailing address

4893 EAST BELTLINE AVE NE SUITE 310
GRAND RAPIDS MI
49525
US

V. Phone/Fax

Practice location:
  • Phone: 616-279-6414
  • Fax: 616-588-6036
Mailing address:
  • Phone: 616-901-5478
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103K00000X
TaxonomyBehavior Analyst
License Number
License Number State

VIII. Authorized Official

Name: MS. TAMMY NEWBERG
Title or Position: MEDICAL INSURANCE SPECILIST
Credential:
Phone: 616-914-9730