Provider Demographics
NPI:1902371792
Name:NOBLE BEHAVIOR
Entity Type:Organization
Organization Name:NOBLE BEHAVIOR
Other - Org Name:NOBLE BEHAVIOR
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:ITZEL
Authorized Official - Middle Name:
Authorized Official - Last Name:ARTEAGA
Authorized Official - Suffix:
Authorized Official - Credentials:BCBA
Authorized Official - Phone:727-265-5394
Mailing Address - Street 1:305 AVENUE K SE
Mailing Address - Street 2:
Mailing Address - City:WINTER HAVEN
Mailing Address - State:FL
Mailing Address - Zip Code:33880-4124
Mailing Address - Country:US
Mailing Address - Phone:727-265-5394
Mailing Address - Fax:863-259-4181
Practice Address - Street 1:116 BATES AVE SW
Practice Address - Street 2:
Practice Address - City:WINTER HAVEN
Practice Address - State:FL
Practice Address - Zip Code:33880-2953
Practice Address - Country:US
Practice Address - Phone:727-265-5394
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-10-08
Last Update Date:2023-12-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL1811319759Medicaid