1326822750 NPI number — BEAUTY AND THE BEHAVIOR, LLC

Table of content: (NPI 1326822750)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1326822750 NPI number — BEAUTY AND THE BEHAVIOR, LLC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
BEAUTY AND THE BEHAVIOR, LLC
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1326822750
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
10/26/2023
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
820 DANA CT
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
GLASGOW
Provider Business Mailing Address State Name:
KY
Provider Business Mailing Address Postal Code:
42141-8753
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
270-535-8593
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
820 DANA CT
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
GLASGOW
Provider Business Practice Location Address State Name:
KY
Provider Business Practice Location Address Postal Code:
42141-8753
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
270-535-8593
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
08/24/2023

Additional Information

Authorized Official

Authorized Official Last Name:
PIPPIN
Authorized Official First Name:
DESTINY
Authorized Official Middle Name:
Authorized Official Title or Position:
OWNER-BCBA
Authorized Official Telephone Number:
270-535-8593

Provider Taxonomy Codes

  • Taxonomy code: 251S00000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 1396443750 . This is a "AETNA BETTER HEALTH OF KY" identifier , issued by the state of ( KY ) . This identifiers is of the category "OTHER".
  • Identifier: 1396443750 . This is a "AETNA" identifier . This identifiers is of the category "OTHER".
  • Identifier: 1396443750 . This is a "HORIZON BCBS OF NEW JERSEY" identifier , issued by the state of ( NJ ) . This identifiers is of the category "OTHER".
  • Identifier: 1396443750 . This is a "MOLINA HEALTHCARE, INC." identifier . This identifiers is of the category "OTHER".
  • Identifier: 7100881450 , issued by the state of ( KY ) . This identifiers is of the category "MEDICAID".
  • Identifier: 1396443750 . This is a "CARELON BEHAVIORAL HEALTH, INC" identifier , issued by the state of ( KY ) . This identifiers is of the category "OTHER".
  • Identifier: 1396443750 . This is a "CENTER CARE HEALTH BENEFIT PROGRAMS" identifier . This identifiers is of the category "OTHER".
  • Identifier: 1396443750 . This is a "HUMANA/CHOICECARE" identifier . This identifiers is of the category "OTHER".
  • Identifier: 1396443750 . This is a "EMPIRE BLUE CROSS BLUE SHIELD/CAREMORE/WELLPOINT MILITARY CARE,AMERIGROUP CORPOR" identifier . This identifiers is of the category "OTHER".
  • Identifier: 1396443750 . This is a "MULTIPLAN, INCORPORATED" identifier . This identifiers is of the category "OTHER".
  • Identifier: 1396443750 . This is a "UNITED BEHAVIORAL HEALTH/US BEHAVIORAL HEALTH PLAN, CALIFORNIA/LIFEERA, INC." identifier . This identifiers is of the category "OTHER".
  • Identifier: 1396443750 . This is a "WELLCARE/CARE1ST" identifier . This identifiers is of the category "OTHER".




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