Healthcare Provider Details

I. General information

NPI: 1083579445
Provider Name (Legal Business Name): ACTION BEHAVIOR CENTERS, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/18/2025
Last Update Date: 12/18/2025
Certification Date: 12/18/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

11672 BENT GRASS MARKET VW STE 120
PEYTON CO
80831-8053
US

IV. Provider business mailing address

6300 BEE CAVES RD BLDG 2-100
AUSTIN TX
78746-5842
US

V. Phone/Fax

Practice location:
  • Phone: 512-920-1030
  • Fax:
Mailing address:
  • Phone: 512-615-5186
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103K00000X
TaxonomyBehavior Analyst
License Number
License Number State

VIII. Authorized Official

Name: SAMANTHA L GOMEZ
Title or Position: CREDENTIALING DIRECTOR
Credential:
Phone: 512-508-3941