Provider Demographics
NPI:1245831676
Name:CLR BEHAVIOR 1 LLC
Entity type:Organization
Organization Name:CLR BEHAVIOR 1 LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:CLARIBEL
Authorized Official - Middle Name:
Authorized Official - Last Name:LAMA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:786-803-6721
Mailing Address - Street 1:391 LEE BLVD STE 200
Mailing Address - Street 2:
Mailing Address - City:LEHIGH ACRES
Mailing Address - State:FL
Mailing Address - Zip Code:33936-4973
Mailing Address - Country:US
Mailing Address - Phone:239-491-2603
Mailing Address - Fax:
Practice Address - Street 1:391 LEE BLVD STE 200
Practice Address - Street 2:
Practice Address - City:LEHIGH ACRES
Practice Address - State:FL
Practice Address - Zip Code:33936-4973
Practice Address - Country:US
Practice Address - Phone:239-491-2603
Practice Address - Fax:239-674-7392
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-11-03
Last Update Date:2025-01-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior AnalystGroup - Multi-Specialty