Healthcare Provider Details

I. General information

NPI: 1912606146
Provider Name (Legal Business Name): THE BEHAVIOR RESOURCE LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/27/2023
Last Update Date: 08/01/2026
Certification Date: 08/01/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5013 CYPRESS LINKS BLVD
ELKTON FL
32033-2032
US

IV. Provider business mailing address

5013 CYPRESS LINKS BLVD
ELKTON FL
32033-2032
US

V. Phone/Fax

Practice location:
  • Phone: 774-210-0665
  • Fax:
Mailing address:
  • Phone: 774-210-0665
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251S00000X
TaxonomyCommunity/Behavioral Health Agency
License Number
License Number State

VIII. Authorized Official

Name: KAYLA M CATE
Title or Position: DIRECTOR
Credential: BCBA
Phone: 774-210-0665