Provider Demographics
NPI:1679318612
Name:ORCHID BEHAVIORAL SERVICES, LLC
Entity type:Organization
Organization Name:ORCHID BEHAVIORAL SERVICES, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MEMBER
Authorized Official - Prefix:
Authorized Official - First Name:AVROHOM
Authorized Official - Middle Name:
Authorized Official - Last Name:BRIMM
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:312-890-1148
Mailing Address - Street 1:8170 MCCORMICK BLVD STE 160B
Mailing Address - Street 2:
Mailing Address - City:SKOKIE
Mailing Address - State:IL
Mailing Address - Zip Code:60076-2961
Mailing Address - Country:US
Mailing Address - Phone:773-232-2281
Mailing Address - Fax:
Practice Address - Street 1:8170 MCCORMICK BLVD. SUITE 160 B
Practice Address - Street 2:
Practice Address - City:SKOKIE
Practice Address - State:IL
Practice Address - Zip Code:60076
Practice Address - Country:US
Practice Address - Phone:312-890-1148
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-07-01
Last Update Date:2024-11-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst