Provider Demographics
NPI:1033732367
Name:BEHAVIOR SKILLS TRAINING LLC
Entity Type:Organization
Organization Name:BEHAVIOR SKILLS TRAINING LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:CONAN
Authorized Official - Middle Name:
Authorized Official - Last Name:CALLEJA
Authorized Official - Suffix:
Authorized Official - Credentials:BCBA
Authorized Official - Phone:561-320-2844
Mailing Address - Street 1:2990 SE 7TH PL
Mailing Address - Street 2:
Mailing Address - City:HOMESTEAD
Mailing Address - State:FL
Mailing Address - Zip Code:33033-5779
Mailing Address - Country:US
Mailing Address - Phone:561-320-2844
Mailing Address - Fax:
Practice Address - Street 1:2990 SE 7TH PL
Practice Address - Street 2:
Practice Address - City:HOMESTEAD
Practice Address - State:FL
Practice Address - Zip Code:33033-5779
Practice Address - Country:US
Practice Address - Phone:561-320-2844
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-05-21
Last Update Date:2023-04-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior AnalystGroup - Single Specialty
No261QH0100XAmbulatory Health Care FacilitiesClinic/CenterHealth ServiceGroup - Single Specialty