Provider Demographics
NPI:1770651317
Name:BEHAVIORAL AWARENESS CENTER, INC
Entity Type:Organization
Organization Name:BEHAVIORAL AWARENESS CENTER, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:BRACKIE
Authorized Official - Middle Name:D
Authorized Official - Last Name:SEKAVEC
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:520-629-9126
Mailing Address - Street 1:2002 W ANKLAM RD
Mailing Address - Street 2:
Mailing Address - City:TUCSON
Mailing Address - State:AZ
Mailing Address - Zip Code:85745-2148
Mailing Address - Country:US
Mailing Address - Phone:520-629-9126
Mailing Address - Fax:520-629-9282
Practice Address - Street 1:2002 W ANKLAM RD
Practice Address - Street 2:
Practice Address - City:TUCSON
Practice Address - State:AZ
Practice Address - Zip Code:85745-2148
Practice Address - Country:US
Practice Address - Phone:520-629-9126
Practice Address - Fax:520-629-9282
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-12-01
Last Update Date:2024-01-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZBH1448101YA0400X
261QM2800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes261QM2800XAmbulatory Health Care FacilitiesClinic/CenterMethadone
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)Group - Single Specialty