Provider Demographics
NPI:1396164745
Name:KEY BEHAVIOR SERVICES, LLC
Entity type:Organization
Organization Name:KEY BEHAVIOR SERVICES, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:HAL
Authorized Official - Middle Name:S
Authorized Official - Last Name:HOUSEWORTH
Authorized Official - Suffix:
Authorized Official - Credentials:BCBA
Authorized Official - Phone:937-952-6379
Mailing Address - Street 1:5963 KENTSHIRE DR # A
Mailing Address - Street 2:
Mailing Address - City:KETTERING
Mailing Address - State:OH
Mailing Address - Zip Code:45440-4253
Mailing Address - Country:US
Mailing Address - Phone:937-952-6379
Mailing Address - Fax:
Practice Address - Street 1:5963 KENTSHIRE DR # A
Practice Address - Street 2:
Practice Address - City:KETTERING
Practice Address - State:OH
Practice Address - Zip Code:45440-4253
Practice Address - Country:US
Practice Address - Phone:937-952-6379
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-04-14
Last Update Date:2023-02-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
1-12-10444103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior AnalystGroup - Single Specialty