Provider Demographics
NPI:1104673367
Name:BENCHMARK BEHAVIOR GROUP LLC
Entity type:Organization
Organization Name:BENCHMARK BEHAVIOR GROUP LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MRS
Authorized Official - First Name:HALEY
Authorized Official - Middle Name:ATES
Authorized Official - Last Name:HUDSON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:334-695-1872
Mailing Address - Street 1:223 N RANDOLPH AVE
Mailing Address - Street 2:
Mailing Address - City:EUFAULA
Mailing Address - State:AL
Mailing Address - Zip Code:36027-1632
Mailing Address - Country:US
Mailing Address - Phone:334-695-1872
Mailing Address - Fax:
Practice Address - Street 1:223 N RANDOLPH AVE
Practice Address - Street 2:
Practice Address - City:EUFAULA
Practice Address - State:AL
Practice Address - Zip Code:36027-1632
Practice Address - Country:US
Practice Address - Phone:334-695-1872
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-05-03
Last Update Date:2024-05-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior AnalystGroup - Single Specialty