Basic Information
| Provider Information | |||||||||
| NPI: | 1588213219 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | BEHAVIOR AND EDUCATION INC | ||||||||
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| Mailing Information | |||||||||
| Address1: | PO BOX 1000 | ||||||||
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| City: | HERMOSA BEACH | ||||||||
| State: | CA | ||||||||
| PostalCode: | 902541000 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3104061500 | ||||||||
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| Practice Location | |||||||||
| Address1: | 6671 LAS VEGAS BLVD S STE 210 | ||||||||
| Address2: | |||||||||
| City: | LAS VEGAS | ||||||||
| State: | NV | ||||||||
| PostalCode: | 891193273 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3104061500 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 09/05/2019 | ||||||||
| LastUpdateDate: | 10/15/2020 | ||||||||
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| AuthorizedOfficialLastName: | RODRIGUEZ | ||||||||
| AuthorizedOfficialFirstName: | ROSA | ||||||||
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| AuthorizedOfficialTitleorPosition: | FINANCE MANAGER | ||||||||
| AuthorizedOfficialTelephone: | 3104061500 | ||||||||
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| IsOrganizationSubpart: | N | ||||||||
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| NPICertificationDate: | 10/15/2020 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 261QM0855X | Y | Ambulatory Health Care Facilities | Clinic/Center | Adolescent and Children Mental Health |
No ID Information.