Organization
SHAPE BEHAVIORAL SERVICES LLC
Active
Other names
Shape Behavioral Services
Organization subpart
No
Provider details
NPI number
Authorized official
ALEX KISS (DIRECTOR)
(423) 281-4333
Entity
Organization
Contact information
Practice address
625 S L ROGERS WELLS BLVD # 218, GLASGOW, KY 42141-1074
(423) 281-4333
Mailing address
625 S L ROGERS WELLS BLVD # 218, GLASGOW, KY 42141-1074
(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
11/22/2021
Last updated
06/05/2023
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