Provider Demographics
NPI:1720802986
Name:GRAHAM BEHAVIOR SERVICES, LLC
Entity type:Organization
Organization Name:GRAHAM BEHAVIOR SERVICES, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:CARA
Authorized Official - Middle Name:MARIE
Authorized Official - Last Name:GRAHAM
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:848-888-3204
Mailing Address - Street 1:60 HIGHWAY 36
Mailing Address - Street 2:
Mailing Address - City:WEST LONG BRANCH
Mailing Address - State:NJ
Mailing Address - Zip Code:07764-1463
Mailing Address - Country:US
Mailing Address - Phone:848-888-3204
Mailing Address - Fax:
Practice Address - Street 1:60 HIGHWAY 36
Practice Address - Street 2:
Practice Address - City:WEST LONG BRANCH
Practice Address - State:NJ
Practice Address - Zip Code:07764-1463
Practice Address - Country:US
Practice Address - Phone:848-888-3204
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:GRAHAM BEHAVIOR SERVICES, LLC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2024-11-13
Last Update Date:2024-11-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior AnalystGroup - Multi-Specialty
No235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language PathologistGroup - Multi-Specialty