Provider Demographics
NPI:1396149233
Name:FAMILY BEHAVIOR SOLUTIONS LLC
Entity type:Organization
Organization Name:FAMILY BEHAVIOR SOLUTIONS LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:DAVID
Authorized Official - Middle Name:
Authorized Official - Last Name:CHARLON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:530-487-7265
Mailing Address - Street 1:55 DECLARATION DR STE B
Mailing Address - Street 2:
Mailing Address - City:CHICO
Mailing Address - State:CA
Mailing Address - Zip Code:95973-4965
Mailing Address - Country:US
Mailing Address - Phone:304-877-2655
Mailing Address - Fax:
Practice Address - Street 1:55 DECLARATION DR STE B
Practice Address - Street 2:
Practice Address - City:CHICO
Practice Address - State:CA
Practice Address - Zip Code:95973-4965
Practice Address - Country:US
Practice Address - Phone:530-487-7265
Practice Address - Fax:530-487-7263
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-10-21
Last Update Date:2019-08-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
252Y00000X
CA1-10-7196103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior AnalystGroup - Single Specialty
No252Y00000XAgenciesEarly Intervention Provider AgencyGroup - Single Specialty