Provider Demographics
NPI:1245831791
Name:BEHAVIOR EVOLUTION
Entity type:Organization
Organization Name:BEHAVIOR EVOLUTION
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MEMBER MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:LAUREN
Authorized Official - Middle Name:
Authorized Official - Last Name:BEATTIE
Authorized Official - Suffix:
Authorized Official - Credentials:BCBA
Authorized Official - Phone:702-275-1418
Mailing Address - Street 1:1920 HOWARD AVE
Mailing Address - Street 2:
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89104-3635
Mailing Address - Country:US
Mailing Address - Phone:702-275-1418
Mailing Address - Fax:702-852-0549
Practice Address - Street 1:1920 HOWARD AVE
Practice Address - Street 2:
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89104-3635
Practice Address - Country:US
Practice Address - Phone:702-275-1418
Practice Address - Fax:702-852-0549
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-11-02
Last Update Date:2024-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior AnalystGroup - Single Specialty