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NPI Code Detail

MEDICARE: BRILLIANT BEHAVIOR LLC

MEDICARE: BRILLIANT BEHAVIOR 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
1106S00000XBehavior Technician
2103K00000XBehavior Analyst

General Provider Information

NPI Number : 1801564190
Entity Type Code : Organization
Provider Name (Legal Business Name) : BRILLIANT BEHAVIOR LLC
Provider Business Mailing Address
First Line : 7260 W AZURE DR STE 140-104
Second Line :
City : LAS VEGAS
State : NV
Zip : 89130-7999
Country : US
Telephone Number : 702-848-2980
Fax Number :
Provider Business Practice Location Address
First Line : 7570 NORMAN ROCKWELL LN STE 250
Second Line :
City : LAS VEGAS
State : NV
Zip : 89143-6013
Country : US
Telephone Number : 702-848-2980
Fax Number :
Authorized Official
Title or Position : MANAGING MEMBER
Name : KARISSA MORRISON
Credential :
Telephone Number : 702-848-2980
Provider Enumeration Date : 09/01/2021
Last Update Date : 05/18/2026

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Directions to “BRILLIANT BEHAVIOR LLC ” Practice Location

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