MEDICARE: RUNSTART BEHAVIOR CONSULTING

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	103K00000X	Behavior Analyst

General Provider Information

NPI Number	:	1336996982
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	RUNSTART BEHAVIOR CONSULTING

Provider Business Mailing Address
First Line	:	4420 ENSIGN AVE APT 407
Second Line	:
City	:	NORTH HOLLYWOOD
State	:	CA
Zip	:	91602-3439
Country	:	US
Telephone Number	:	443-642-1579
Fax Number	:

Provider Business Practice Location Address
First Line	:	4420 ENSIGN AVE APT 407
Second Line	:
City	:	NORTH HOLLYWOOD
State	:	CA
Zip	:	91602-3439
Country	:	US
Telephone Number	:	443-642-1579
Fax Number	:

Authorized Official
Title or Position	:	OWNER
Name	:	MR. JUSTIN RESNICK
Credential	:	BCBA
Telephone Number	:	443-642-1579

Provider Enumeration Date	:	05/01/2024
Last Update Date	:	05/01/2024

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Directions to “RUNSTART BEHAVIOR CONSULTING ” Practice Location

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