Provider Demographics
NPI:1851125561
Name:BEHAVIORSPAN
Entity type:Organization
Organization Name:BEHAVIORSPAN
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:DR
Authorized Official - First Name:J
Authorized Official - Middle Name:JAMES
Authorized Official - Last Name:TOMASH
Authorized Official - Suffix:
Authorized Official - Credentials:PHD, BCBA-D
Authorized Official - Phone:720-717-9009
Mailing Address - Street 1:2111 S DAHLIA ST
Mailing Address - Street 2:
Mailing Address - City:DENVER
Mailing Address - State:CO
Mailing Address - Zip Code:80222-5105
Mailing Address - Country:US
Mailing Address - Phone:720-717-9009
Mailing Address - Fax:
Practice Address - Street 1:2111 S DAHLIA ST
Practice Address - Street 2:
Practice Address - City:DENVER
Practice Address - State:CO
Practice Address - Zip Code:80222-5105
Practice Address - Country:US
Practice Address - Phone:720-717-9009
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:BEHAVIORSPAN
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2024-08-27
Last Update Date:2024-08-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior AnalystGroup - Single Specialty