MEDICARE: AVENTURA BEHAVIOR THERAPY

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	103K00000X	Behavior Analyst

General Provider Information

NPI Number	:	1184570566
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	AVENTURA BEHAVIOR THERAPY

Provider Business Mailing Address
First Line	:	3720 N SHIMMONS CIR
Second Line	:
City	:	AUBURN HILLS
State	:	MI
Zip	:	48326-3914
Country	:	US
Telephone Number	:	248-214-8610
Fax Number	:	248-484-6528

Provider Business Practice Location Address
First Line	:	3720 N SHIMMONS CIR
Second Line	:
City	:	AUBURN HILLS
State	:	MI
Zip	:	48326-3914
Country	:	US
Telephone Number	:	248-214-8610
Fax Number	:	248-484-6528

Authorized Official
Title or Position	:	OWNER
Name	:	GRIZEL BARRAGAN
Credential	:
Telephone Number	:	248-214-8610

Provider Enumeration Date	:	03/07/2026
Last Update Date	:	03/07/2026

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