Provider Demographics
NPI:1609484674
Name:BETTER KIDS BEHAVIORAL THERAPY
Entity Type:Organization
Organization Name:BETTER KIDS BEHAVIORAL THERAPY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:JORGE
Authorized Official - Middle Name:
Authorized Official - Last Name:RIVERO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:305-562-2106
Mailing Address - Street 1:12485 SW 137TH AVE STE 210
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33186-4217
Mailing Address - Country:US
Mailing Address - Phone:305-562-2106
Mailing Address - Fax:
Practice Address - Street 1:6719 WINKLER RD STE 116
Practice Address - Street 2:
Practice Address - City:FORT MYERS
Practice Address - State:FL
Practice Address - Zip Code:33919-7200
Practice Address - Country:US
Practice Address - Phone:305-562-2106
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-07-16
Last Update Date:2020-07-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior AnalystGroup - Single Specialty