Provider Demographics
NPI:1033988894
Name:VOYAGE BEHAVIOR, INC.
Entity Type:Organization
Organization Name:VOYAGE BEHAVIOR, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:BCBA OWNER, CEO, & PRESIDENT
Authorized Official - Prefix:MISS
Authorized Official - First Name:AMANDA
Authorized Official - Middle Name:LYNN
Authorized Official - Last Name:GRAY
Authorized Official - Suffix:
Authorized Official - Credentials:MS, BCBA, IBA, LBA
Authorized Official - Phone:833-869-2423
Mailing Address - Street 1:9783 E 116TH ST # 1094
Mailing Address - Street 2:
Mailing Address - City:FISHERS
Mailing Address - State:IN
Mailing Address - Zip Code:46037-2822
Mailing Address - Country:US
Mailing Address - Phone:833-869-2423
Mailing Address - Fax:863-869-6727
Practice Address - Street 1:2202 MANDARIN LOOP
Practice Address - Street 2:
Practice Address - City:DUNDEE
Practice Address - State:FL
Practice Address - Zip Code:33838-4387
Practice Address - Country:US
Practice Address - Phone:833-869-2423
Practice Address - Fax:863-869-6727
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:VOYAGE BEHAVIOR, INC.
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2023-12-21
Last Update Date:2023-12-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior AnalystGroup - Multi-Specialty
No106E00000XBehavioral Health & Social Service ProvidersAssistant Behavior AnalystGroup - Multi-Specialty
No106S00000XBehavioral Health & Social Service ProvidersBehavior TechnicianGroup - Multi-Specialty
No251S00000XAgenciesCommunity/Behavioral HealthGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL1629620042OtherNPI MAIN OFFICE
FL114235500Medicaid