| Lassen Aba Llc | |
|
388 Richmond Rd Susanville CA 96130-4606 | |
| (530) 251-7374 | |
| (530) 257-8857 |
| Full Name | Lassen Aba Llc |
|---|---|
| Speciality | Behavior Analyst |
| Location | 388 Richmond Rd, Susanville, California |
| Authorized Official Name and Position | Keith Bussey (OWNER) |
| Authorized Official Contact | 5302517374 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Lassen Aba Llc 388 Richmond Rd Susanville CA 96130-4606 Ph: (530) 251-7374 | Lassen Aba Llc 388 Richmond Rd Susanville CA 96130-4606 Ph: (530) 251-7374 |
| NPI Number | 1790345205 |
|---|---|
| Provider Enumeration Date | 06/17/2019 |
| Last Update Date | 06/17/2019 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1790345205 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 103K00000X | Behavior Analyst | (* (Not Available)) | Primary |
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