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General NPI Number Information
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NPI Number | 1811387012
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Entity Type | Organization
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Legal Business Name | BEHAVIOR SERVICES OF NEW ENGLAND
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Dates
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Enumeration Date | 01/27/2015
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Last Update Date | 01/27/2015
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Provider Practice Location Address
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Address Line | 185 FABYAN RD
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City | NORTH GROSVENORDALE
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State | CT
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Zip | 06255-1506
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Country | US
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Telephone | 860-315-0565
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Fax | 860-315-0565
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Provider Business Mailing Address
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Address Line | 185 FABYAN RD
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City | NORTH GROSVENORDALE
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State | CT
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Zip | 06255-1506
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Country | US
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Telephone | 860-315-0565
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Fax | 860-315-0565
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Authorized Official
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Title or Position | MANAGER
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Name | DR. MICHAEL WEINBERG
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Credential | PH.D., LP, BCBA-D
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Telephone | 860-315-0565
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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 | 002562
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License Number State | CT
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