Provider Demographics
NPI:1578719589
Name:BEHAVIOR FOR LIFE, INC.
Entity Type:Organization
Organization Name:BEHAVIOR FOR LIFE, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR OF CLINICAL SERVICES
Authorized Official - Prefix:DR
Authorized Official - First Name:AMY
Authorized Official - Middle Name:LYNN
Authorized Official - Last Name:DILLREE
Authorized Official - Suffix:
Authorized Official - Credentials:PHD
Authorized Official - Phone:254-833-3744
Mailing Address - Street 1:4606 CAUSEWAY CT
Mailing Address - Street 2:
Mailing Address - City:KILLEEN
Mailing Address - State:TX
Mailing Address - Zip Code:76549-3990
Mailing Address - Country:US
Mailing Address - Phone:254-628-0374
Mailing Address - Fax:
Practice Address - Street 1:809 S W S YOUNG DR
Practice Address - Street 2:
Practice Address - City:KILLEEN
Practice Address - State:TX
Practice Address - Zip Code:76543-4801
Practice Address - Country:US
Practice Address - Phone:254-383-0458
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-08-09
Last Update Date:2008-08-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX1-06-2769251S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health