Provider Demographics
NPI:1164132411
Name:BEHAVE, EDUCATE, AND ENGAGE LLC
Entity Type:Organization
Organization Name:BEHAVE, EDUCATE, AND ENGAGE LLC
Other - Org Name:BEEKIDSUTAH
Other - Org Type:Other Name
Authorized Official - Title/Position:OWNER/ BCBA
Authorized Official - Prefix:
Authorized Official - First Name:BRENNA
Authorized Official - Middle Name:
Authorized Official - Last Name:WAGNER
Authorized Official - Suffix:
Authorized Official - Credentials:MSC, BCBA, LBA
Authorized Official - Phone:435-840-8166
Mailing Address - Street 1:88 E 1000 N
Mailing Address - Street 2:
Mailing Address - City:TOOELE
Mailing Address - State:UT
Mailing Address - Zip Code:84074-9693
Mailing Address - Country:US
Mailing Address - Phone:435-249-0934
Mailing Address - Fax:
Practice Address - Street 1:88 E 1000 N
Practice Address - Street 2:
Practice Address - City:TOOELE
Practice Address - State:UT
Practice Address - Zip Code:84074-9693
Practice Address - Country:US
Practice Address - Phone:435-249-0934
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-11-28
Last Update Date:2022-11-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior AnalystGroup - Multi-Specialty