Provider Demographics
NPI:1639664790
Name:BEHAVIOR AND THERAPY CONSULTANTS INC.
Entity Type:Organization
Organization Name:BEHAVIOR AND THERAPY CONSULTANTS INC.
Other - Org Name:BEHAVIOR AND THERAPY CONSULTANTS INC.
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:YAIBISLEIVYS
Authorized Official - Middle Name:
Authorized Official - Last Name:CRUZ
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:786-352-0299
Mailing Address - Street 1:12905 SW 42ND ST STE 113
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33175-2910
Mailing Address - Country:US
Mailing Address - Phone:786-352-0299
Mailing Address - Fax:
Practice Address - Street 1:12905 SW 42ND ST STE 113
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33175-2910
Practice Address - Country:US
Practice Address - Phone:786-352-0299
Practice Address - Fax:305-386-3132
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-06-29
Last Update Date:2021-09-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior AnalystGroup - Multi-Specialty
No251E00000XAgenciesHome HealthGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL024098100Medicaid