Provider Demographics
NPI:1891475810
Name:BEHAVIORAL CARE THERAPY, INC
Entity Type:Organization
Organization Name:BEHAVIORAL CARE THERAPY, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/BCBA
Authorized Official - Prefix:
Authorized Official - First Name:SARA
Authorized Official - Middle Name:
Authorized Official - Last Name:JOHNSON
Authorized Official - Suffix:
Authorized Official - Credentials:BCBA
Authorized Official - Phone:909-359-2487
Mailing Address - Street 1:1140 DICKENSON CT
Mailing Address - Street 2:
Mailing Address - City:UPLAND
Mailing Address - State:CA
Mailing Address - Zip Code:91786-3431
Mailing Address - Country:US
Mailing Address - Phone:909-359-2487
Mailing Address - Fax:
Practice Address - Street 1:3200 E GUASTI RD STE 100
Practice Address - Street 2:
Practice Address - City:ONTARIO
Practice Address - State:CA
Practice Address - Zip Code:91761-8661
Practice Address - Country:US
Practice Address - Phone:909-359-2487
Practice Address - Fax:909-639-4147
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-07-24
Last Update Date:2023-07-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes252Y00000XAgenciesEarly Intervention Provider Agency
No251S00000XAgenciesCommunity/Behavioral Health