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Organization

BLACKWEST, LLC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
MRS. HAILEY BLACKSTOCK BCBA (CEO)
(678) 965-0653
Entity
Organization

Contact information

Practice address
703 ATLANTA RD, CUMMING, GA 30040-2705
(770) 886-6204
Mailing address
703 ATLANTA RD, CUMMING, GA 30040-2705
(770) 886-6204

Taxonomy

Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary

Other

Enumeration date
08/21/2020
Last updated
03/01/2023
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