Provider Demographics
NPI:1275275976
Name:1ST BEHAVIOR THERAPY GROUP INC
Entity Type:Organization
Organization Name:1ST BEHAVIOR THERAPY GROUP INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT/OWNER
Authorized Official - Prefix:
Authorized Official - First Name:YANEPSY
Authorized Official - Middle Name:
Authorized Official - Last Name:SANTOS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:305-896-4251
Mailing Address - Street 1:4160 W 16TH AVE STE 504-505
Mailing Address - Street 2:
Mailing Address - City:HIALEAH
Mailing Address - State:FL
Mailing Address - Zip Code:33012-5830
Mailing Address - Country:US
Mailing Address - Phone:305-896-4251
Mailing Address - Fax:305-640-5469
Practice Address - Street 1:4160 W 16TH AVE STE 504-505
Practice Address - Street 2:
Practice Address - City:HIALEAH
Practice Address - State:FL
Practice Address - Zip Code:33012-5830
Practice Address - Country:US
Practice Address - Phone:305-896-4251
Practice Address - Fax:305-640-5469
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-04-12
Last Update Date:2022-04-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261Q00000XAmbulatory Health Care FacilitiesClinic/Center