Provider Demographics
NPI:1316258411
Name:QUALITY BEHAVIORAL INTERVENTIONS AND CONSULTING, LLC
Entity type:Organization
Organization Name:QUALITY BEHAVIORAL INTERVENTIONS AND CONSULTING, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:MR
Authorized Official - First Name:CEDRIC
Authorized Official - Middle Name:D
Authorized Official - Last Name:NELSON
Authorized Official - Suffix:
Authorized Official - Credentials:MA ED
Authorized Official - Phone:901-282-5490
Mailing Address - Street 1:1017 CORDOVA RIDGE PL
Mailing Address - Street 2:
Mailing Address - City:CORDOVA
Mailing Address - State:TN
Mailing Address - Zip Code:38018-0103
Mailing Address - Country:US
Mailing Address - Phone:901-282-5490
Mailing Address - Fax:901-255-0619
Practice Address - Street 1:1017 CORDOVA RIDGE PL
Practice Address - Street 2:
Practice Address - City:CORDOVA
Practice Address - State:TN
Practice Address - Zip Code:38018-0103
Practice Address - Country:US
Practice Address - Phone:901-282-5490
Practice Address - Fax:901-255-0619
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-06-24
Last Update Date:2010-06-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health