Basic Information
| Provider Information | |||||||||
| NPI: | 1437493749 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | BEHAVIORAL LEARNING CENTER | ||||||||
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| Mailing Information | |||||||||
| Address1: | 27240 TURNBERRY LN STE 240 | ||||||||
| Address2: | |||||||||
| City: | VALENCIA | ||||||||
| State: | CA | ||||||||
| PostalCode: | 913551017 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6612547086 | ||||||||
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| Address1: | 27240 TURNBERRY LN STE 240 | ||||||||
| Address2: | |||||||||
| City: | VALENCIA | ||||||||
| State: | CA | ||||||||
| PostalCode: | 913551017 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6612547086 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 11/27/2012 | ||||||||
| LastUpdateDate: | 11/27/2012 | ||||||||
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| AuthorizedOfficialLastName: | STAWINSKI | ||||||||
| AuthorizedOfficialFirstName: | JACKIE | ||||||||
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| AuthorizedOfficialTitleorPosition: | ASSISTANT CLINICAL DIRECTOR | ||||||||
| AuthorizedOfficialTelephone: | 6612547086 | ||||||||
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| IsOrganizationSubpart: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 251S00000X | 11211851 | CA | Y | Agencies | Community/Behavioral Health |
No ID Information.