Provider Demographics
NPI:1629620042
Name:VOYAGE BEHAVIOR, INC.
Entity Type:Organization
Organization Name:VOYAGE BEHAVIOR, INC.
Other - Org Name:VOYAGE BEHAVIOR
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CEO &PRESIDENT
Authorized Official - Prefix:MISS
Authorized Official - First Name:AMANDA
Authorized Official - Middle Name:LYNN
Authorized Official - Last Name:GRAY
Authorized Official - Suffix:
Authorized Official - Credentials:MS, BCBA, IBA, LBA
Authorized Official - Phone:833-869-2423
Mailing Address - Street 1:2202 MANDARIN LOOP
Mailing Address - Street 2:
Mailing Address - City:DUNDEE
Mailing Address - State:FL
Mailing Address - Zip Code:33838-4387
Mailing Address - Country:US
Mailing Address - Phone:833-869-2423
Mailing Address - Fax:863-869-6727
Practice Address - Street 1:2202 MANDARIN LOOP
Practice Address - Street 2:
Practice Address - City:DUNDEE
Practice Address - State:FL
Practice Address - Zip Code:33838-4387
Practice Address - Country:US
Practice Address - Phone:833-869-2423
Practice Address - Fax:863-869-6727
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-07-15
Last Update Date:2023-07-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior AnalystGroup - Multi-Specialty
No106E00000XBehavioral Health & Social Service ProvidersAssistant Behavior AnalystGroup - Multi-Specialty
No106S00000XBehavioral Health & Social Service ProvidersBehavior TechnicianGroup - Multi-Specialty
No251S00000XAgenciesCommunity/Behavioral HealthGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL114235500Medicaid