| Family Model Behavior Therapy, Llc | |
|
18802 Mandan Street #901 Canyon Country CA 91351 | |
| (818) 261-5580 | |
| (661) 367-7778 |
| Full Name | Family Model Behavior Therapy, Llc |
|---|---|
| Speciality | Behavior Analyst |
| Location | 18802 Mandan Street, Canyon Country, California |
| Authorized Official Name and Position | Keegan Hart (CLINICAL DIRECTOR/OWNER) |
| Authorized Official Contact | 8182615580 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Family Model Behavior Therapy, Llc 18802 Mandan Street #901 Canyon Country CA 91351 Ph: (818) 261-5580 | Family Model Behavior Therapy, Llc 18802 Mandan Street #901 Canyon Country CA 91351 Ph: (818) 261-5580 |
| NPI Number | 1750898177 |
|---|---|
| Provider Enumeration Date | 01/08/2018 |
| Last Update Date | 01/08/2018 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1750898177 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 103K00000X | Behavior Analyst | 1-15-18352 (California) | Primary |
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Family Model Behavior Therapy Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 18802 Mandan Street, #901, Canyon Country, CA 91351 Phone: 818-261-5580 Fax: 661-367-7778 |