Provider Demographics
NPI:1841912482
Name:BEHAVIOR CONNECTIONS LLC
Entity type:Organization
Organization Name:BEHAVIOR CONNECTIONS LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:BEHAVIOR ANALYSTS/ OWNER
Authorized Official - Prefix:MRS
Authorized Official - First Name:REBECCA
Authorized Official - Middle Name:
Authorized Official - Last Name:AVILES
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:407-808-8680
Mailing Address - Street 1:571 JUNIPER SPRINGS DR
Mailing Address - Street 2:
Mailing Address - City:GROVELAND
Mailing Address - State:FL
Mailing Address - Zip Code:34736-8117
Mailing Address - Country:US
Mailing Address - Phone:407-808-8680
Mailing Address - Fax:
Practice Address - Street 1:1779 VALE DR
Practice Address - Street 2:
Practice Address - City:CLERMONT
Practice Address - State:FL
Practice Address - Zip Code:34711-5100
Practice Address - Country:US
Practice Address - Phone:407-808-8680
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-09-12
Last Update Date:2022-09-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior AnalystGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL050912Medicaid