Provider Demographics
NPI:1730205303
Name:INSTITUTE FOR BEHAVORIAL CHANGE AND RESEARCH
Entity type:Organization
Organization Name:INSTITUTE FOR BEHAVORIAL CHANGE AND RESEARCH
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:HOWARD
Authorized Official - Middle Name:
Authorized Official - Last Name:MABRY
Authorized Official - Suffix:
Authorized Official - Credentials:PHD
Authorized Official - Phone:202-675-8315
Mailing Address - Street 1:PO BOX 6716
Mailing Address - Street 2:
Mailing Address - City:WASHINGTON
Mailing Address - State:DC
Mailing Address - Zip Code:20020-0416
Mailing Address - Country:US
Mailing Address - Phone:202-675-8315
Mailing Address - Fax:202-675-8319
Practice Address - Street 1:401 H ST NE
Practice Address - Street 2:
Practice Address - City:WASHINGTON
Practice Address - State:DC
Practice Address - Zip Code:20002-4335
Practice Address - Country:US
Practice Address - Phone:202-675-8315
Practice Address - Fax:202-675-8319
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-22
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health