Provider Demographics
NPI:1518543446
Name:TRUST BEHAVIOR THERAPY L.L.C.
Entity Type:Organization
Organization Name:TRUST BEHAVIOR THERAPY L.L.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:ROXANA
Authorized Official - Middle Name:C
Authorized Official - Last Name:BETACOURT
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:786-554-9222
Mailing Address - Street 1:8906 W FLAGLER ST APT 114
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33174-3910
Mailing Address - Country:US
Mailing Address - Phone:786-554-9222
Mailing Address - Fax:
Practice Address - Street 1:11025 SW 180TH ST
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33157-5025
Practice Address - Country:US
Practice Address - Phone:786-554-9222
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-03-22
Last Update Date:2021-03-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health