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General NPI Number Information
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NPI Number | 1326480542
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Entity Type | Organization
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Legal Business Name | SAGE BEHAVIOR SERVICES
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Dates
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Enumeration Date | 07/30/2013
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Last Update Date | 07/30/2013
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Provider Practice Location Address
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Address Line | 1435 N HARBOR BLVD 124
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City | FULLERTON
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State | CA
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Zip | 92835-4105
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Country | US
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Telephone | 714-425-2442
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Fax |
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Provider Business Mailing Address
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Address Line | 825 TAMARACK AVE 104
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City | BREA
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State | CA
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Zip | 92821-2550
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Country | US
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Telephone | 714-425-2442
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Fax |
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Authorized Official
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Title or Position | SENIOR PROGRAM SUPERVISOR
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Name | MR. STEVEN CHON SCHLEICHER
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Credential | M. ED
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Telephone | 714-425-2442
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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 |
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License Number State |
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