Provider Demographics
NPI:1225848237
Name:RTL BEHAVIORAL SERVICES
Entity type:Organization
Organization Name:RTL BEHAVIORAL SERVICES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER, CEO
Authorized Official - Prefix:
Authorized Official - First Name:LA KRISTA
Authorized Official - Middle Name:LEE ANN
Authorized Official - Last Name:KING
Authorized Official - Suffix:
Authorized Official - Credentials:BCBA
Authorized Official - Phone:573-825-5207
Mailing Address - Street 1:1243 EL CORTEZ CT
Mailing Address - Street 2:
Mailing Address - City:CHULA VISTA
Mailing Address - State:CA
Mailing Address - Zip Code:91910-8187
Mailing Address - Country:US
Mailing Address - Phone:573-825-5207
Mailing Address - Fax:
Practice Address - Street 1:1243 EL CORTEZ CT
Practice Address - Street 2:
Practice Address - City:CHULA VISTA
Practice Address - State:CA
Practice Address - Zip Code:91910-8187
Practice Address - Country:US
Practice Address - Phone:573-825-5207
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-01-10
Last Update Date:2025-01-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes252Y00000XAgenciesEarly Intervention Provider Agency
No251C00000XAgenciesDay Training, Developmentally Disabled Services