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Organization

IMAGINE BEHAVIORAL & DEVELOPMENTAL SERVICES

Active
Parent organization
CARAVEL AUTISM HEALTH, LLC
Other names
SL Start & Associates, LLC
Organization subpart
Yes

Provider details

NPI number
Legal business name
CARAVEL AUTISM HEALTH, LLC
Authorized official
HEIDI MORAGO (CREDENTIALING SPECIALIST)
(920) 857-9041
Entity
Organization

Contact information

Practice address
5709 W SUNSET HWY STE 101, SPOKANE, WA 99224-9446
(509) 209-2739
(920) 857-3366
Mailing address
1575 ALLOUEZ AVE, GREEN BAY, WI 54311-5639
(920) 857-9041
(920) 857-3366

Taxonomy

Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
103TC0700X
Clinical Psychologist
251S00000X
Community/Behavioral Health Agency
Primary

Other

Enumeration date
11/26/2012
Last updated
06/10/2021
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