Provider Demographics
NPI:1972873768
Name:CENTER FOR BEHAVIOR INTERVENTION, INC
Entity Type:Organization
Organization Name:CENTER FOR BEHAVIOR INTERVENTION, INC
Other - Org Name:CBI
Other - Org Type:Other Name
Authorized Official - Title/Position:CFO
Authorized Official - Prefix:
Authorized Official - First Name:JONATHON
Authorized Official - Middle Name:
Authorized Official - Last Name:CURLETT
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:512-772-4042
Mailing Address - Street 1:19056 HENRY DR
Mailing Address - Street 2:
Mailing Address - City:MOKENA
Mailing Address - State:IL
Mailing Address - Zip Code:60448-9302
Mailing Address - Country:US
Mailing Address - Phone:708-995-5751
Mailing Address - Fax:
Practice Address - Street 1:19056 HENRY DR
Practice Address - Street 2:
Practice Address - City:MOKENA
Practice Address - State:IL
Practice Address - Zip Code:60448-9302
Practice Address - Country:US
Practice Address - Phone:708-995-5751
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:CULTIVATE BEHAVIORAL MANAGEMENT CORP
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2012-01-10
Last Update Date:2022-02-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL1 11 8054103K00000X
IL1 07 3922103K00000X
103K00000X, 251S00000X
IL251C00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior AnalystGroup - Multi-Specialty
No251C00000XAgenciesDay Training, Developmentally Disabled ServicesGroup - Multi-Specialty
No251S00000XAgenciesCommunity/Behavioral HealthGroup - Single Specialty