Provider Demographics
NPI:1851134605
Name:ELITE BEHAVIORAL SERVICE LLC
Entity type:Organization
Organization Name:ELITE BEHAVIORAL SERVICE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:DARRELL
Authorized Official - Middle Name:
Authorized Official - Last Name:BROWN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:317-513-1846
Mailing Address - Street 1:8383 CRAIG ST STE 330
Mailing Address - Street 2:
Mailing Address - City:INDIANAPOLIS
Mailing Address - State:IN
Mailing Address - Zip Code:46250-3541
Mailing Address - Country:US
Mailing Address - Phone:317-513-1846
Mailing Address - Fax:877-200-8921
Practice Address - Street 1:8383 CRAIG ST STE 330
Practice Address - Street 2:
Practice Address - City:INDIANAPOLIS
Practice Address - State:IN
Practice Address - Zip Code:46250-3541
Practice Address - Country:US
Practice Address - Phone:317-513-1846
Practice Address - Fax:877-200-8921
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-06-18
Last Update Date:2024-06-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior AnalystGroup - Single Specialty
No261QM0801XAmbulatory Health Care FacilitiesClinic/CenterMental Health (Including Community Mental Health Center)Group - Single Specialty