Provider Demographics
NPI:1326393687
Name:BUILDING SUCCESSFUL TRANSITIONS
Entity type:Organization
Organization Name:BUILDING SUCCESSFUL TRANSITIONS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT/CEO
Authorized Official - Prefix:DR
Authorized Official - First Name:MARY
Authorized Official - Middle Name:M
Authorized Official - Last Name:FALLIE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:818-761-6617
Mailing Address - Street 1:12810 ARMINTA ST
Mailing Address - Street 2:
Mailing Address - City:NORTH HOLLYWOOD
Mailing Address - State:CA
Mailing Address - Zip Code:91605-2018
Mailing Address - Country:US
Mailing Address - Phone:818-761-6617
Mailing Address - Fax:818-761-6617
Practice Address - Street 1:12810 ARMINTA ST
Practice Address - Street 2:
Practice Address - City:NORTH HOLLYWOOD
Practice Address - State:CA
Practice Address - Zip Code:91605-2018
Practice Address - Country:US
Practice Address - Phone:818-761-6617
Practice Address - Fax:818-761-6617
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:UNITED NEIGHBORHOOD DEVELOPMENT CORPORATION
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2012-07-23
Last Update Date:2012-07-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAPSB 33492103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior AnalystGroup - Single Specialty