Healthcare Provider Details

I. General information

NPI: 1629620042
Provider Name (Legal Business Name): VOYAGE BEHAVIOR, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/15/2019
Last Update Date: 11/06/2025
Certification Date: 11/06/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2202 MANDARIN LOOP
DUNDEE FL
33838-4387
US

IV. Provider business mailing address

2202 MANDARIN LOOP
DUNDEE FL
33838-4387
US

V. Phone/Fax

Practice location:
  • Phone: 321-486-9243
  • Fax: 321-486-9329
Mailing address:
  • Phone: 321-486-9243
  • Fax: 321-486-9329

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103K00000X
TaxonomyBehavior Analyst
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code106E00000X
TaxonomyAssistant Behavior Analyst
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code106S00000X
TaxonomyBehavior Technician
License Number
License Number State
# 4
Primary TaxonomyN
Taxonomy Code251S00000X
TaxonomyCommunity/Behavioral Health Agency
License Number
License Number State

VIII. Authorized Official

Name: MISS AMANDA LYNN GRAY
Title or Position: BCBA
Credential: M.S., BCBA, CTP
Phone: 321-486-9243