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General NPI Number Information
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NPI Number | 1194991778
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Entity Type | Organization
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Legal Business Name | BEHAVIOR SPECIALISTS OF INDIANA, LLC
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Dates
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Enumeration Date | 05/05/2008
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Last Update Date | 05/05/2008
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Provider Practice Location Address
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Address Line | 2611A CHICAGO ST
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City | VALPARAISO
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State | IN
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Zip | 46383-6111
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Country | US
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Telephone | 219-462-6705
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Fax | 219-464-4318
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Provider Business Mailing Address
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Address Line | 2611A CHICAGO ST
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City | VALPARAISO
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State | IN
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Zip | 46383-6111
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Country | US
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Telephone | 219-462-6705
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Fax | 219-464-4318
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Authorized Official
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Title or Position | EXECUTIVE DIRECTOR
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Name | ROBERT R. SCHNEIDER
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Credential |
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Telephone | 219-462-6705
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251S00000X
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Taxonomy Name | Community/Behavioral Health Agency
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License Number | 20041239
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License Number State | IN
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