MEDICARE: BEHAVIOR AND LANGUAGE TREATMENT CENTER

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	251S00000X	Community/Behavioral Health Agency	629358	TX
2	251C00000X	Developmentally Disabled Services Day Training Agency	629358	TX

General Provider Information

NPI Number	:	1922384403
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	BEHAVIOR AND LANGUAGE TREATMENT CENTER

Provider Business Mailing Address
First Line	:	PO BOX 1168
Second Line	:
City	:	LINDALE
State	:	TX
Zip	:	75771-1168
Country	:	US
Telephone Number	:	903-520-6243
Fax Number	:	903-496-0298

Provider Business Practice Location Address
First Line	:	14623 FM 849
Second Line	:
City	:	LINDALE
State	:	TX
Zip	:	75771-2440
Country	:	US
Telephone Number	:	903-520-6243
Fax Number	:	903-496-0298

Authorized Official
Title or Position	:	OWNER
Name	:	KIMBERLY ELAINE BUTLER
Credential	:	RN
Telephone Number	:	903-520-6243

Provider Enumeration Date	:	10/27/2011
Last Update Date	:	07/15/2024

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Directions to “BEHAVIOR AND LANGUAGE TREATMENT CENTER ” Practice Location

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