Healthcare Provider Details

I. General information

NPI: 1669891644
Provider Name (Legal Business Name): BEHAVIORAL CONCEPTS LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/07/2014
Last Update Date: 09/27/2022
Certification Date: 09/27/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

23041 AVENDIA DE LA CARLOTA
LAGUNA HILLS CA
92653-1511
US

IV. Provider business mailing address

BEHAVIORAL CONCEPTS LLC 23041 AVENDIA DE LA CARLOTA
LAGUNA HILLS CA
92653-1511
US

V. Phone/Fax

Practice location:
  • Phone: 949-954-4422
  • Fax: 714-242-1611
Mailing address:
  • Phone: 949-954-4422
  • Fax: 714-242-1611

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103K00000X
TaxonomyBehavior Analyst
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code320600000X
TaxonomyIntellectual and/or Developmental Disabilities Residential Treatment Facility
License Number1-13-12788
License Number StateCA

VIII. Authorized Official

Name: MS. CLAUDIA C RIQUELME
Title or Position: CLINICAL EXECUTIVE DIRECTOR
Credential: BCBA
Phone: 949-235-3719