Community Behavior Support, Inc.

Primary specialty

Community/Behavioral Health AgencyTaxonomy code 251S00000X

License

1011-03-002 Issued in VA

Legal business name

COMMUNITY BEHAVIOR SUPPORT, INC.

Practice address

804 Anglia CT
VA. Beach
Virginia Beach, VA 23464-2381

Phone

(757) 277-3552

Fax

(757) 299-8005

NPI assigned

Oct 4, 2016

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Mr. Olusegun F Ososanya, MA. PSYCH.

Title

Owner/Ceo

Phone

(757) 277-3552

Specialties & licenses 1

Addresses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1475539200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1475539200000",
    "number": "1205386182",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "804 ANGLIA CT",
            "address_2": "VA. BEACH",
            "city": "VIRGINIA BEACH",
            "state": "VA",
            "postal_code": "234642381",
            "telephone_number": "757-277-3552",
            "fax_number": "757-299-8005"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "804 ANGLIA CT",
            "address_2": "VA. BEACH",
            "city": "VIRGINIA BEACH",
            "state": "VA",
            "postal_code": "234642381",
            "telephone_number": "757-277-3552",
            "fax_number": "757-299-8005"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "COMMUNITY BEHAVIOR SUPPORT, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-10-04",
        "last_updated": "2016-10-04",
        "status": "A",
        "authorized_official_last_name": "OSOSANYA",
        "authorized_official_first_name": "OLUSEGUN",
        "authorized_official_middle_name": "F",
        "authorized_official_title_or_position": "OWNER/CEO",
        "authorized_official_telephone_number": "757-277-3552",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "MA. PSYCH."
    },
    "taxonomies": [
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": "VA",
            "license": "1011-03-002",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Community/Behavioral Health Agency in Virginia Beach, VA
• Providers in Virginia Beach, VA by specialty
• Community/Behavioral Health Agency in Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 4, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.