Provider Demographics
NPI:1215310222
Name:BRIMMER BEHAVIORAL SERVICES LLC
Entity type:Organization
Organization Name:BRIMMER BEHAVIORAL SERVICES LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:BCBA, LBS
Authorized Official - Prefix:
Authorized Official - First Name:REGINA
Authorized Official - Middle Name:
Authorized Official - Last Name:BRIMMER
Authorized Official - Suffix:
Authorized Official - Credentials:MS
Authorized Official - Phone:814-853-7499
Mailing Address - Street 1:PO BOX 671
Mailing Address - Street 2:
Mailing Address - City:PINE GROVE MILLS
Mailing Address - State:PA
Mailing Address - Zip Code:16868-0671
Mailing Address - Country:US
Mailing Address - Phone:814-853-7499
Mailing Address - Fax:
Practice Address - Street 1:127 CLEMSON CT
Practice Address - Street 2:
Practice Address - City:STATE COLLEGE
Practice Address - State:PA
Practice Address - Zip Code:16803-1178
Practice Address - Country:US
Practice Address - Phone:814-853-7499
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-07-08
Last Update Date:2015-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PA001503103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior AnalystGroup - Single Specialty