Provider Demographics
NPI:1861078214
Name:PEAKS AND VALLEYS BEHAVIOR SERVICES LLC
Entity type:Organization
Organization Name:PEAKS AND VALLEYS BEHAVIOR SERVICES LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CLINICAL DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:ANGEL
Authorized Official - Middle Name:
Authorized Official - Last Name:PATTERSON
Authorized Official - Suffix:
Authorized Official - Credentials:BCBA
Authorized Official - Phone:267-210-8577
Mailing Address - Street 1:2300 LASSO DR
Mailing Address - Street 2:
Mailing Address - City:ROUND ROCK
Mailing Address - State:TX
Mailing Address - Zip Code:78681-7391
Mailing Address - Country:US
Mailing Address - Phone:267-210-8577
Mailing Address - Fax:
Practice Address - Street 1:2300 LASSO DR
Practice Address - Street 2:
Practice Address - City:ROUND ROCK
Practice Address - State:TX
Practice Address - Zip Code:78681-7391
Practice Address - Country:US
Practice Address - Phone:267-210-8577
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-03-23
Last Update Date:2021-03-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior AnalystGroup - Multi-Specialty