Healthcare Provider Details

I. General information

NPI: 1508586454
Provider Name (Legal Business Name): CHASING BEHAVIOR MODIFICATION CORP
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/31/2022
Last Update Date: 10/01/2026
Certification Date: 10/01/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3905 CRESCENT PARK DR
RIVERVIEW FL
33578-3625
US

IV. Provider business mailing address

3905 CRESCENT PARK DR # 124
RIVERVIEW FL
33578-3625
US

V. Phone/Fax

Practice location:
  • Phone: 813-399-4975
  • Fax: 800-370-1116
Mailing address:
  • Phone: 813-399-4975
  • Fax: 561-202-8506

VI. Provider taxonomy

Scope of Practice (Provider specialty)

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

VIII. Authorized Official

Name: MARIA EUGENIA GARCIA
Title or Position: OWNER
Credential:
Phone: 732-589-9551