Provider Demographics
NPI:1154604338
Name:POSITIVE BEHAVIORAL SOLUTIONS LLC
Entity type:Organization
Organization Name:POSITIVE BEHAVIORAL SOLUTIONS LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:TERESA
Authorized Official - Middle Name:L
Authorized Official - Last Name:FORMAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:606-261-6262
Mailing Address - Street 1:6055 STATE HIGHWAY 174
Mailing Address - Street 2:
Mailing Address - City:OLIVE HILL
Mailing Address - State:KY
Mailing Address - Zip Code:41164-8849
Mailing Address - Country:US
Mailing Address - Phone:606-261-6262
Mailing Address - Fax:
Practice Address - Street 1:6055 STATE HIGHWAY 174
Practice Address - Street 2:
Practice Address - City:OLIVE HILL
Practice Address - State:KY
Practice Address - Zip Code:41164-8849
Practice Address - Country:US
Practice Address - Phone:606-261-6262
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-09-23
Last Update Date:2011-09-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health