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
500 8TH ST, ANN ARBOR, MI 48103-4754
(423) 281-4333
Mailing address
847 SUMPTER RD UNIT 5118, VAN BUREN TWP, MI 48111-4905
(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
12/01/2021
Last updated
06/05/2023
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