Healthcare Provider Details

I. General information

NPI: 1083334221
Provider Name (Legal Business Name): BEHAVIOR CLUB
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/29/2022
Last Update Date: 06/05/2026
Certification Date: 06/05/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1901 CALDWELL BLVD # 1063
NAMPA ID
83651-1506
US

IV. Provider business mailing address

1901 CALDWELL BLVD # 1063
NAMPA ID
83651-1506
US

V. Phone/Fax

Practice location:
  • Phone: 208-907-4038
  • Fax: 208-992-0246
Mailing address:
  • Phone: 208-907-4038
  • Fax: 208-992-0246

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251C00000X
TaxonomyDevelopmentally Disabled Services Day Training Agency
License Number
License Number State

VIII. Authorized Official

Name: DR. SARAH LAMANA
Title or Position: OWNER, BCBA
Credential: DHSC, BCBA
Phone: 208-907-4038