Provider Demographics
NPI:1235917733
Name:CENTURY BEHAVIOR THERAPY LLC
Entity Type:Organization
Organization Name:CENTURY BEHAVIOR THERAPY LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:MONICA
Authorized Official - Middle Name:
Authorized Official - Last Name:GONZALEZ MOLLEDA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:786-985-0634
Mailing Address - Street 1:9411 SW 36TH ST
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33165-4005
Mailing Address - Country:US
Mailing Address - Phone:786-985-0634
Mailing Address - Fax:
Practice Address - Street 1:1805 PONCE DE LEON BLVD STE 100
Practice Address - Street 2:
Practice Address - City:CORAL GABLES
Practice Address - State:FL
Practice Address - Zip Code:33134-4444
Practice Address - Country:US
Practice Address - Phone:786-985-0634
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-09-18
Last Update Date:2023-09-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior AnalystGroup - Multi-Specialty