Provider Demographics
NPI:1518420322
Name:BEHAVIORCRAFT LLC
Entity Type:Organization
Organization Name:BEHAVIORCRAFT LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:ZACK
Authorized Official - Middle Name:
Authorized Official - Last Name:MIGIOIA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:757-333-1861
Mailing Address - Street 1:772 GREAT MARSH AVE
Mailing Address - Street 2:
Mailing Address - City:CHESAPEAKE
Mailing Address - State:VA
Mailing Address - Zip Code:23320-6360
Mailing Address - Country:US
Mailing Address - Phone:757-333-1861
Mailing Address - Fax:
Practice Address - Street 1:772 GREAT MARSH AVE
Practice Address - Street 2:
Practice Address - City:CHESAPEAKE
Practice Address - State:VA
Practice Address - Zip Code:23320-6360
Practice Address - Country:US
Practice Address - Phone:757-333-1861
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-04-09
Last Update Date:2019-04-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior AnalystGroup - Multi-Specialty