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Organization
FAMILY MODEL BEHAVIOR THERAPY, LLC
Active
Organization
FAMILY MODEL BEHAVIOR THERAPY, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
KEEGAN HART BCBA (CLINICAL DIRECTOR/OWNER)
(818) 261-5580
Entity
Organization
Contact information
Practice address
18802 MANDAN STREET, #901, CANYON COUNTRY, CA 91351
(818) 261-5580
(661) 367-7778
Mailing address
18802 MANDAN STREET, #901, CANYON COUNTRY, CA 91351
(818) 261-5580
(661) 367-7778
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
1-15-18352
CA
Other
Enumeration date
01/08/2018
Last updated
01/08/2018
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