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NPI Code Detail

MEDICARE: ACTION BEHAVIOR CENTERS, LLC

MEDICARE: ACTION BEHAVIOR CENTERS, LLC
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
1103K00000XBehavior Analyst
2103T00000XPsychologist

General Provider Information

NPI Number : 1447003397
Entity Type Code : Organization
Provider Name (Legal Business Name) : ACTION BEHAVIOR CENTERS, LLC
Provider Business Mailing Address
First Line : 1601 S MOPAC EXPY STE C300
Second Line :
City : AUSTIN
State : TX
Zip : 78746-7077
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 7001 TOWER RD STE C-2
Second Line :
City : DENVER
State : CO
Zip : 80249-7381
Country : US
Telephone Number : 303-406-9550
Fax Number :
Authorized Official
Title or Position : CREDENTIALING MANAGER
Name : SAMANTHA L GOMEZ
Credential :
Telephone Number : 512-508-3941
Provider Enumeration Date : 04/10/2024
Last Update Date : 12/18/2024

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Directions to “ACTION BEHAVIOR CENTERS, LLC ” Practice Location

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