Organization
BRAVO BEHAVIORAL HEALTH LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MARK HARTMAN (CEO)
(833) 272-8624
Entity
Organization
Contact information
Practice address
8140 MCCORMICK BLVD STE 141, SKOKIE, IL 60076-2920
(833) 272-8624
Mailing address
8140 MCCORMICK BLVD STE 141, SKOKIE, IL 60076-2920
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
—
—
106E00000X
Assistant Behavior Analyst
—
—
106S00000X
Behavior Technician
—
—
2084B0040X
Behavioral Neurology & Neuropsychiatry Physician
—
—
2084N0402X
Neurology with Special Qualifications in Child Neurology Physician
—
—
2084P0005X
Neurodevelopmental Disabilities Physician
—
—
Other
Enumeration date
07/12/2018
Last updated
07/12/2018
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