Organization
BEHAVIORAL AUTISM THERAPIES, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. LARRY HUMPHREYS BCBA (PROGRAM DIRECTOR)
(626) 893-5046
Entity
Organization
Contact information
Practice address
20926 BLACK STALLION DR, COVINA, CA 91724-3849
(626) 893-5046
(626) 502-1178
Mailing address
20926 BLACK STALLION DR, COVINA, CA 91724-3849
(626) 893-5046
(626) 502-1178
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
Primary
1-11-8431
CA
Other
Enumeration date
03/05/2012
Last updated
03/05/2012
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