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General NPI Number Information
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NPI Number | 1629884960
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Entity Type | Organization
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Legal Business Name | LARK BEHAVIOR GROUP LLC
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Dates
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Enumeration Date | 12/10/2024
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Last Update Date | 12/10/2024
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Provider Practice Location Address
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Address Line | 18200 RINALDI PL
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City | PORTER RANCH
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State | CA
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Zip | 91326-2551
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Country | US
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Telephone | 818-916-0295
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Fax | 818-724-7704
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Provider Business Mailing Address
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Address Line | 9722 PINE ORCHARD ST
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City | PACOIMA
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State | CA
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Zip | 91331-6905
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | MANAGING DIRECTOR
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Name | MR. STEVEN BOGHOSKHAN
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Credential |
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Telephone | 818-813-1803
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 103T00000X
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Taxonomy Name | Psychologist
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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 | 225X00000X
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Taxonomy Name | Occupational Therapist
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 235Z00000X
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Taxonomy Name | Speech-Language Pathologist
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License Number |
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License Number State |
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Taxonomy #4
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Taxonomy Code | 103K00000X
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Taxonomy Name | Behavior Analyst
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License Number |
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License Number State |
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