Provider Demographics
NPI:1497502504
Name:NATIONAL BEHAVIORAL THERAPY SERVICES LLC
Entity type:Organization
Organization Name:NATIONAL BEHAVIORAL THERAPY SERVICES LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MS
Authorized Official - First Name:FARZANA
Authorized Official - Middle Name:
Authorized Official - Last Name:ISLAM
Authorized Official - Suffix:
Authorized Official - Credentials:MED QBHP
Authorized Official - Phone:713-448-9918
Mailing Address - Street 1:835 LOUISA ST STE 205
Mailing Address - Street 2:
Mailing Address - City:LANSING
Mailing Address - State:MI
Mailing Address - Zip Code:48911-5200
Mailing Address - Country:US
Mailing Address - Phone:313-497-2665
Mailing Address - Fax:
Practice Address - Street 1:835 LOUISA ST STE 205
Practice Address - Street 2:
Practice Address - City:LANSING
Practice Address - State:MI
Practice Address - Zip Code:48911-5200
Practice Address - Country:US
Practice Address - Phone:313-497-2665
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-05-06
Last Update Date:2024-11-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health
No261QM0801XAmbulatory Health Care FacilitiesClinic/CenterMental Health (Including Community Mental Health Center)
No253Z00000XAgenciesIn Home Supportive Care