Provider Demographics
NPI:1255003943
Name:ACTION BEHAVIOR CENTERS, LLC
Entity Type:Organization
Organization Name:ACTION BEHAVIOR CENTERS, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CREDENTIALING MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:SAMANTHA
Authorized Official - Middle Name:L
Authorized Official - Last Name:GOMEZ
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:512-551-1717
Mailing Address - Street 1:1601 S MOPAC EXPY
Mailing Address - Street 2:SUITE C-300
Mailing Address - City:AUSTIN
Mailing Address - State:TX
Mailing Address - Zip Code:78746
Mailing Address - Country:US
Mailing Address - Phone:512-920-1239
Mailing Address - Fax:512-957-0699
Practice Address - Street 1:3301 W 144TH AVE UNIT 100
Practice Address - Street 2:
Practice Address - City:BROOMFIELD
Practice Address - State:CO
Practice Address - Zip Code:80023-9511
Practice Address - Country:US
Practice Address - Phone:512-920-1239
Practice Address - Fax:512-957-0699
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-09-30
Last Update Date:2022-08-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior AnalystGroup - Single Specialty