Provider Demographics
NPI:1932752375
Name:PREPARING INDIVIDUALS TODAY FOR TOMORROW LLC
Entity type:Organization
Organization Name:PREPARING INDIVIDUALS TODAY FOR TOMORROW LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CLINICAL SERVICE EXECUTIVE
Authorized Official - Prefix:
Authorized Official - First Name:SADIQ
Authorized Official - Middle Name:
Authorized Official - Last Name:LOCUS
Authorized Official - Suffix:
Authorized Official - Credentials:MS, BCBA, LBS
Authorized Official - Phone:484-335-6100
Mailing Address - Street 1:PO BOX 20503
Mailing Address - Street 2:
Mailing Address - City:LEHIGH VALLEY
Mailing Address - State:PA
Mailing Address - Zip Code:18002-0503
Mailing Address - Country:US
Mailing Address - Phone:484-335-6100
Mailing Address - Fax:484-335-6104
Practice Address - Street 1:4443 CIRCLE DR
Practice Address - Street 2:
Practice Address - City:BETHLEHEM
Practice Address - State:PA
Practice Address - Zip Code:18020-9607
Practice Address - Country:US
Practice Address - Phone:484-335-6100
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-07-23
Last Update Date:2019-08-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior AnalystGroup - Multi-Specialty
No106S00000XBehavioral Health & Social Service ProvidersBehavior TechnicianGroup - Multi-Specialty
No251S00000XAgenciesCommunity/Behavioral HealthGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA1-19-35788OtherBACB