Provider Demographics
NPI:1255175907
Name:OJL BEHAVIORAL THERAPY CORP
Entity type:Organization
Organization Name:OJL BEHAVIORAL THERAPY CORP
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:ORESTE
Authorized Official - Middle Name:J
Authorized Official - Last Name:LORES
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:786-624-1412
Mailing Address - Street 1:10585 SW 109TH CT STE 204
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33176-3309
Mailing Address - Country:US
Mailing Address - Phone:786-656-1270
Mailing Address - Fax:786-615-5784
Practice Address - Street 1:10585 SW 109TH CT STE 204
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33176-3309
Practice Address - Country:US
Practice Address - Phone:786-624-1412
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-06-19
Last Update Date:2025-05-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior AnalystGroup - Single Specialty