Organization
MGA BEHAVIOR THERAPY LLC
Active
Parent organization
MGA BEHAVIOR THERAPY LLC
Organization subpart
Yes
Provider details
NPI number
Legal business name
MGA BEHAVIOR THERAPY LLC
Authorized official
ALEXANDRA KOLOSKUS ESQ (CHIEF COMPLIANCE OFFICER)
(720) 276-7706
Entity
Organization
Contact information
Practice address
3400 WALSH PKWY STE 248, FAYETTEVILLE, NC 28311-1642
(910) 839-0239
Mailing address
1355 GARDEN OF THE GODS RD STE 130, COLORADO SPRINGS, CO 80907-3595
(719) 212-6535
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
Primary
—
—
Other
Enumeration date
09/18/2023
Last updated
09/18/2023
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