Provider Demographics
NPI:1194252759
Name:AIM BEHAVIOR SERVICES, LLC
Entity type:Organization
Organization Name:AIM BEHAVIOR SERVICES, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:LANCE
Authorized Official - Middle Name:
Authorized Official - Last Name:HAVENS
Authorized Official - Suffix:
Authorized Official - Credentials:BCBA
Authorized Official - Phone:213-915-8277
Mailing Address - Street 1:851 BOWSPRIT RD
Mailing Address - Street 2:
Mailing Address - City:CHULA VISTA
Mailing Address - State:CA
Mailing Address - Zip Code:91914-4529
Mailing Address - Country:US
Mailing Address - Phone:213-915-8277
Mailing Address - Fax:844-609-0034
Practice Address - Street 1:1759 OCEANSIDE BLVD STE C118
Practice Address - Street 2:
Practice Address - City:OCEANSIDE
Practice Address - State:CA
Practice Address - Zip Code:92054-3470
Practice Address - Country:US
Practice Address - Phone:213-915-8277
Practice Address - Fax:844-609-0034
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-05-15
Last Update Date:2021-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA1-15-21047103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior AnalystGroup - Single Specialty