Provider Demographics
NPI:1235015140
Name:POSITIVE BEHAVIOR SUPPORT
Entity type:Organization
Organization Name:POSITIVE BEHAVIOR SUPPORT
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:BEHAVIOR TECHNICIAN
Authorized Official - Prefix:
Authorized Official - First Name:AMIYA
Authorized Official - Middle Name:T
Authorized Official - Last Name:PATRICK
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:251-525-6176
Mailing Address - Street 1:122 JOHNSTON ST
Mailing Address - Street 2:
Mailing Address - City:CHICKASAW
Mailing Address - State:AL
Mailing Address - Zip Code:36611-1850
Mailing Address - Country:US
Mailing Address - Phone:251-525-6176
Mailing Address - Fax:
Practice Address - Street 1:122 JOHNSTON ST
Practice Address - Street 2:
Practice Address - City:CHICKASAW
Practice Address - State:AL
Practice Address - Zip Code:36611-1850
Practice Address - Country:US
Practice Address - Phone:251-525-6176
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2025-08-14
Last Update Date:2025-08-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health