Provider Demographics
NPI:1003336173
Name:ADVANCE BEHAVIOR COALITION INC
Entity Type:Organization
Organization Name:ADVANCE BEHAVIOR COALITION INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:HECTOR
Authorized Official - Middle Name:J
Authorized Official - Last Name:SALAZAR
Authorized Official - Suffix:JR
Authorized Official - Credentials:
Authorized Official - Phone:305-733-9005
Mailing Address - Street 1:14531 SW 157TH CT
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33196-6748
Mailing Address - Country:US
Mailing Address - Phone:786-200-2726
Mailing Address - Fax:
Practice Address - Street 1:14531 SW 157TH CT
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33196-6748
Practice Address - Country:US
Practice Address - Phone:305-733-9005
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-06-21
Last Update Date:2018-05-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior AnalystGroup - Multi-Specialty