Provider Demographics
NPI:1497912935
Name:AMERICAN BEHAVIOR CENTER
Entity Type:Organization
Organization Name:AMERICAN BEHAVIOR CENTER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:LICENSED PROFESSIONAL COUNSELOR
Authorized Official - Prefix:
Authorized Official - First Name:SHADIA
Authorized Official - Middle Name:B
Authorized Official - Last Name:KHOURY
Authorized Official - Suffix:
Authorized Official - Credentials:MED, LPC
Authorized Official - Phone:830-775-5100
Mailing Address - Street 1:PO BOX 420397
Mailing Address - Street 2:
Mailing Address - City:DEL RIO
Mailing Address - State:TX
Mailing Address - Zip Code:78842-0397
Mailing Address - Country:US
Mailing Address - Phone:830-775-5100
Mailing Address - Fax:830-775-5188
Practice Address - Street 1:104 FLETCHER DR
Practice Address - Street 2:SUITE C
Practice Address - City:DEL RIO
Practice Address - State:TX
Practice Address - Zip Code:78840-3083
Practice Address - Country:US
Practice Address - Phone:830-775-5100
Practice Address - Fax:830-775-5188
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-05-21
Last Update Date:2008-05-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX62156101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Multi-Specialty