Provider Demographics
NPI:1194013375
Name:NEUROBEHAVIORAL CONCEPTS LLC
Entity type:Organization
Organization Name:NEUROBEHAVIORAL CONCEPTS LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PRINCIPAL/ THERAPIST
Authorized Official - Prefix:MR
Authorized Official - First Name:LONNY
Authorized Official - Middle Name:RAY
Authorized Official - Last Name:WEBB
Authorized Official - Suffix:
Authorized Official - Credentials:MSW
Authorized Official - Phone:503-803-9361
Mailing Address - Street 1:1344 14TH ST
Mailing Address - Street 2:
Mailing Address - City:WEST LINN
Mailing Address - State:OR
Mailing Address - Zip Code:97068-4531
Mailing Address - Country:US
Mailing Address - Phone:503-803-9361
Mailing Address - Fax:
Practice Address - Street 1:1344 14TH ST
Practice Address - Street 2:
Practice Address - City:WEST LINN
Practice Address - State:OR
Practice Address - Zip Code:97068-4531
Practice Address - Country:US
Practice Address - Phone:503-803-9361
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-07-21
Last Update Date:2011-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0855XAmbulatory Health Care FacilitiesClinic/CenterAdolescent and Children Mental Health
No261Q00000XAmbulatory Health Care FacilitiesClinic/Center
No261QM0801XAmbulatory Health Care FacilitiesClinic/CenterMental Health (Including Community Mental Health Center)