| Behavior Change Success Corp | |
|
331 Eastlake Ave Massapequa Park NY 11762-1836 | |
| (516) 640-0798 | |
| Not Available |
| Full Name | Behavior Change Success Corp |
|---|---|
| Speciality | Community/behavioral Health |
| Location | 331 Eastlake Ave, Massapequa Park, New York |
| Authorized Official Name and Position | Denise Victoria Wright (DIRECTOR) |
| Authorized Official Contact | 5167991045 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Behavior Change Success Corp 331 Eastlake Ave Massapequa Park NY 11762-1836 Ph: (516) 640-0798 | Behavior Change Success Corp 331 Eastlake Ave Massapequa Park NY 11762-1836 Ph: (516) 640-0798 |
| NPI Number | 1821307406 |
|---|---|
| Provider Enumeration Date | 09/30/2010 |
| Last Update Date | 09/30/2010 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1821307406 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 251S00000X | Community/behavioral Health | 1095079 (New York) | Primary |
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