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General NPI Number Information
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NPI Number | 1427329630
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Entity Type | Organization
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Legal Business Name | APPLIED BEHAVIORAL HEALTH CONSULTANTS, LLC
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Dates
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Enumeration Date | 01/19/2012
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Last Update Date | 01/11/2017
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Provider Practice Location Address
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Address Line | 400 LOCUST ST SUITE # 400
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City | DES MOINES
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State | IA
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Zip | 50309-2331
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Country | US
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Telephone | 515-664-2881
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Fax | 515-223-2371
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Provider Business Mailing Address
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Address Line | PO BOX 997
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City | DES MOINES
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State | IA
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Zip | 50304-0997
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Country | US
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Telephone | 515-664-2881
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Fax | 515-223-2371
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Authorized Official
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Title or Position | OPERATING OFFICER
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Name | DR. DANIEL EPHRAIM POTT-PEPPERMAN
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Credential | PSY.D.
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Telephone | 515-664-2881
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 310400000X
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Taxonomy Name | Assisted Living Facility
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License Number | 3564
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License Number State | CO
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Taxonomy #2
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Taxonomy Code | 313M00000X
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Taxonomy Name | Nursing Facility/Intermediate Care Facility
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License Number | 001024
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License Number State | IA
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