Healthcare Provider Details
I. General information
NPI: 1245539394
Provider Name (Legal Business Name): BEHAVIOR FRONTIERS, LLC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 03/15/2011
Last Update Date: 08/22/2025
Certification Date: 08/22/2025
Deactivation Date:
Reactivation Date:
III. Provider practice location address
1149 W 190TH ST STE 2200
GARDENA CA
90248-4344
US
IV. Provider business mailing address
100 N PACIFIC COAST HWY STE 1400
EL SEGUNDO CA
90245-5602
US
V. Phone/Fax
- Phone: 310-856-0800
- Fax: 855-568-2494
- Phone: 310-856-0800
- Fax: 855-568-2494
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 103K00000X |
| Taxonomy | Behavior Analyst |
| License Number | |
| License Number State | |
| # 2 | |
| Primary Taxonomy | N |
| Taxonomy Code | 251S00000X |
| Taxonomy | Community/Behavioral Health Agency |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
HELEN
MADER
Title or Position: CLINICAL DIRECTOR/OWNER
Credential: M.A., B.C.B.A.
Phone: 310-856-0800