Provider Demographics
NPI:1427802818
Name:BEHAVIOR SPECTRUM THERAPY LLC
Entity type:Organization
Organization Name:BEHAVIOR SPECTRUM THERAPY LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:AMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:NIURYSEL
Authorized Official - Middle Name:
Authorized Official - Last Name:ARAGON GUERRA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:305-769-4936
Mailing Address - Street 1:7755 W 4TH AVE STE 104
Mailing Address - Street 2:
Mailing Address - City:HIALEAH
Mailing Address - State:FL
Mailing Address - Zip Code:33014-4265
Mailing Address - Country:US
Mailing Address - Phone:305-769-4936
Mailing Address - Fax:305-769-1844
Practice Address - Street 1:7755 W 4TH AVE STE 104
Practice Address - Street 2:
Practice Address - City:HIALEAH
Practice Address - State:FL
Practice Address - Zip Code:33014-4265
Practice Address - Country:US
Practice Address - Phone:305-769-4936
Practice Address - Fax:305-769-1844
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-04-12
Last Update Date:2024-04-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior AnalystGroup - Multi-Specialty