Provider Demographics
NPI:1699087122
Name:BEHAVIORAL CONSULTING SERVICE, LLC
Entity type:Organization
Organization Name:BEHAVIORAL CONSULTING SERVICE, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:BUSINESS MANAGER
Authorized Official - Prefix:MR
Authorized Official - First Name:JAMES
Authorized Official - Middle Name:ANTHONY
Authorized Official - Last Name:WALLACE
Authorized Official - Suffix:
Authorized Official - Credentials:BBA
Authorized Official - Phone:631-940-1156
Mailing Address - Street 1:188 OAKFIELD AVE
Mailing Address - Street 2:
Mailing Address - City:DIX HILLS
Mailing Address - State:NY
Mailing Address - Zip Code:11746-6305
Mailing Address - Country:US
Mailing Address - Phone:631-940-1156
Mailing Address - Fax:
Practice Address - Street 1:188 OAKFIELD AVE
Practice Address - Street 2:
Practice Address - City:DIX HILLS
Practice Address - State:NY
Practice Address - Zip Code:11746-6305
Practice Address - Country:US
Practice Address - Phone:631-940-1156
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-07-13
Last Update Date:2010-07-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health