Provider Demographics
NPI:1285310383
Name:KALAMAZOO ACADEMY FOR BEHAVIORAL AND ACADEMIC SUCCESS
Entity type:Organization
Organization Name:KALAMAZOO ACADEMY FOR BEHAVIORAL AND ACADEMIC SUCCESS
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:SR. DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:MARGARET
Authorized Official - Middle Name:
Authorized Official - Last Name:UWAYO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:269-633-9218
Mailing Address - Street 1:2595 N 10TH ST
Mailing Address - Street 2:
Mailing Address - City:KALAMAZOO
Mailing Address - State:MI
Mailing Address - Zip Code:49009-9185
Mailing Address - Country:US
Mailing Address - Phone:269-633-9218
Mailing Address - Fax:
Practice Address - Street 1:2595 N 10TH ST
Practice Address - Street 2:
Practice Address - City:KALAMAZOO
Practice Address - State:MI
Practice Address - Zip Code:49009-9185
Practice Address - Country:US
Practice Address - Phone:269-633-9218
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-06-23
Last Update Date:2023-06-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior AnalystGroup - Single Specialty