Provider Demographics
NPI:1588320253
Name:BEHAVIOR MANAGEMENT CENTER INC
Entity type:Organization
Organization Name:BEHAVIOR MANAGEMENT CENTER INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OFFICER
Authorized Official - Prefix:MRS
Authorized Official - First Name:YACSA
Authorized Official - Middle Name:
Authorized Official - Last Name:FLEITES VALDES
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:786-606-4348
Mailing Address - Street 1:4226 DEL PRADO BLVD S
Mailing Address - Street 2:
Mailing Address - City:CAPE CORAL
Mailing Address - State:FL
Mailing Address - Zip Code:33904-7168
Mailing Address - Country:US
Mailing Address - Phone:786-606-4348
Mailing Address - Fax:
Practice Address - Street 1:4226 DEL PRADO BLVD S
Practice Address - Street 2:
Practice Address - City:CAPE CORAL
Practice Address - State:FL
Practice Address - Zip Code:33904-7168
Practice Address - Country:US
Practice Address - Phone:786-606-4348
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-11-16
Last Update Date:2025-02-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior AnalystGroup - Multi-Specialty