Provider Demographics
NPI:1699272948
Name:APPLIED BEHAVIORAL SCIENCE INSTITUTION LLC
Entity type:Organization
Organization Name:APPLIED BEHAVIORAL SCIENCE INSTITUTION LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MEDICAL INSURANCE SPECILIST
Authorized Official - Prefix:MS
Authorized Official - First Name:TAMMY
Authorized Official - Middle Name:
Authorized Official - Last Name:NEWBERG
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:616-279-6414
Mailing Address - Street 1:4893 EAST BELTLINE AVE NE
Mailing Address - Street 2:SUITE 310
Mailing Address - City:GRAND RAPIDS
Mailing Address - State:MI
Mailing Address - Zip Code:49525
Mailing Address - Country:US
Mailing Address - Phone:616-901-5478
Mailing Address - Fax:
Practice Address - Street 1:4893 EAST BELTLINE AVE NE
Practice Address - Street 2:SUITE 310
Practice Address - City:GRAND RAPIDS
Practice Address - State:MI
Practice Address - Zip Code:49525
Practice Address - Country:US
Practice Address - Phone:616-901-5478
Practice Address - Fax:616-588-6036
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-04-11
Last Update Date:2024-06-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior AnalystGroup - Single Specialty