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General NPI Number Information
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NPI Number | 1225848237
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Entity Type | Organization
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Legal Business Name | RTL BEHAVIORAL SERVICES
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Dates
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Enumeration Date | 01/10/2025
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Last Update Date | 01/10/2025
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Provider Practice Location Address
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Address Line | 1243 EL CORTEZ CT
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City | CHULA VISTA
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State | CA
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Zip | 91910-8187
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Country | US
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Telephone | 573-825-5207
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Fax |
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Provider Business Mailing Address
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Address Line | 1243 EL CORTEZ CT
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City | CHULA VISTA
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State | CA
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Zip | 91910-8187
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Country | US
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Telephone | 573-825-5207
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Fax |
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Authorized Official
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Title or Position | OWNER, CEO
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Name | LA KRISTA LEE ANN KING
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Credential | BCBA
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Telephone | 573-825-5207
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251C00000X
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Taxonomy Name | Developmentally Disabled Services Day Training Agency
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 252Y00000X
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Taxonomy Name | Early Intervention Provider Agency
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License Number |
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License Number State |
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