Provider Demographics
NPI:1255004321
Name:ACHIEVABLE BEHAVIOR OUTCOMES
Entity Type:Organization
Organization Name:ACHIEVABLE BEHAVIOR OUTCOMES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:RENE
Authorized Official - Middle Name:
Authorized Official - Last Name:LEON
Authorized Official - Suffix:
Authorized Official - Credentials:BCBA
Authorized Official - Phone:407-431-5787
Mailing Address - Street 1:3969 NIGHT HERON DR
Mailing Address - Street 2:
Mailing Address - City:SANFORD
Mailing Address - State:FL
Mailing Address - Zip Code:32773-7399
Mailing Address - Country:US
Mailing Address - Phone:407-431-5787
Mailing Address - Fax:
Practice Address - Street 1:3969 NIGHT HERON DR
Practice Address - Street 2:
Practice Address - City:SANFORD
Practice Address - State:FL
Practice Address - Zip Code:32773-7399
Practice Address - Country:US
Practice Address - Phone:407-431-5787
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-07-26
Last Update Date:2021-07-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior AnalystGroup - Single Specialty