MEDICARE: BEHAVIORAL INTERVENTION SERVICES, INC.

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	251C00000X	Developmentally Disabled Services Day Training Agency	1052482	TN

General Provider Information

NPI Number	:	1689839938
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	BEHAVIORAL INTERVENTION SERVICES, INC.

Provider Business Mailing Address
First Line	:	2617 BELLE MEADE DR NE
Second Line	:
City	:	HUNTSVILLE
State	:	AL
Zip	:	35811-1909
Country	:	US
Telephone Number	:	256-527-8061
Fax Number	:

Provider Business Practice Location Address
First Line	:	2617 BELLE MEADE DR NE
Second Line	:
City	:	HUNTSVILLE
State	:	AL
Zip	:	35811-1909
Country	:	US
Telephone Number	:	256-527-8061
Fax Number	:

Authorized Official
Title or Position	:	BEHAVIOR ANALYST
Name	:	MRS. MICHELLE BRANDY WORTHY
Credential	:	BCBA
Telephone Number	:	256-527-8061

Provider Enumeration Date	:	07/25/2008
Last Update Date	:	07/25/2008

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