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Organization
SHAPE BEHAVIORAL SERVICES LLC
Active
Organization
SHAPE BEHAVIORAL SERVICES LLC
Active
Other names
Shape Behavioral Services LLC
Organization subpart
No
Provider details
NPI number
Authorized official
ALEX KISS (DIRECTOR)
(423) 281-4333
Entity
Organization
Contact information
Practice address
107 SOUTH INDIANA AVE, BLOOMINGTON, IN 47405
(423) 281-4333
Mailing address
722 S LIBERTY ST STE 218, MUNCIE, IN 47305-2346
(423) 281-4333
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
—
—
106E00000X
Assistant Behavior Analyst
—
—
106S00000X
Behavior Technician
—
—
251S00000X
Community/Behavioral Health Agency
—
—
Other
Enumeration date
12/02/2021
Last updated
06/05/2023
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