Provider Demographics
NPI:1255080412
Name:BEHAVIOR ANALYSIS AND THERAPY, INC.
Entity type:Organization
Organization Name:BEHAVIOR ANALYSIS AND THERAPY, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATIVE SUPERVISOR
Authorized Official - Prefix:
Authorized Official - First Name:CLAUDIT
Authorized Official - Middle Name:
Authorized Official - Last Name:CASANOVA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:954-577-7790
Mailing Address - Street 1:8001 SW 36TH ST STE 9
Mailing Address - Street 2:
Mailing Address - City:DAVIE
Mailing Address - State:FL
Mailing Address - Zip Code:33328-1915
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:4150 FORD ST
Practice Address - Street 2:
Practice Address - City:FORT MYERS
Practice Address - State:FL
Practice Address - Zip Code:33916-9498
Practice Address - Country:US
Practice Address - Phone:954-577-7790
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-03-23
Last Update Date:2022-03-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior TechnicianGroup - Single Specialty
No103K00000XBehavioral Health & Social Service ProvidersBehavior AnalystGroup - Single Specialty