Provider Demographics
NPI:1083150841
Name:BEHAVIOR ANALYSIS CENTER CORP
Entity Type:Organization
Organization Name:BEHAVIOR ANALYSIS CENTER CORP
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:IVAN
Authorized Official - Middle Name:
Authorized Official - Last Name:RUIZ
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:786-717-6311
Mailing Address - Street 1:9280 HAMMOCKS BLVD
Mailing Address - Street 2:SUITE 101
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33196-1507
Mailing Address - Country:US
Mailing Address - Phone:786-717-6311
Mailing Address - Fax:786-717-6818
Practice Address - Street 1:9280 HAMMOCKS BLVD
Practice Address - Street 2:SUITE 101
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33196-1507
Practice Address - Country:US
Practice Address - Phone:786-717-6311
Practice Address - Fax:786-717-6818
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-01-17
Last Update Date:2017-01-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior AnalystGroup - Single Specialty