Healthcare Provider Details

I. General information

NPI: 1356588446
Provider Name (Legal Business Name): BEHAVIOR ANALYTIC SOLUTIONS, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/12/2009
Last Update Date: 03/23/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4502 CENTERVIEW SUITE 215
SAN ANTONIO TX
78228-1318
US

IV. Provider business mailing address

4502 CENTERVIEW SUITE 215
SAN ANTONIO TX
78228-1318
US

V. Phone/Fax

Practice location:
  • Phone: 210-733-7440
  • Fax: 210-733-7570
Mailing address:
  • Phone: 210-733-7440
  • Fax: 210-733-7570

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code251C00000X
TaxonomyDevelopmentally Disabled Services Day Training Agency
License Number1020994
License Number StateTX
# 2
Primary TaxonomyN
Taxonomy Code225X00000X
TaxonomyOccupational Therapist
License Number
License Number StateTX
# 3
Primary TaxonomyN
Taxonomy Code225XF0002X
TaxonomyFeeding, Eating & Swallowing Occupational Therapist
License Number
License Number StateTX
# 4
Primary TaxonomyN
Taxonomy Code225XP0200X
TaxonomyPediatric Occupational Therapist
License Number
License Number StateTX
# 5
Primary TaxonomyN
Taxonomy Code103K00000X
TaxonomyBehavior Analyst
License Number1-02-0994
License Number StateTX
# 6
Primary TaxonomyY
Taxonomy Code235Z00000X
TaxonomySpeech-Language Pathologist
License Number
License Number StateTX

VIII. Authorized Official

Name: MR. LUPE CASTANEDA JR.
Title or Position: PRESIDENT/CEO
Credential: BCBA
Phone: 210-316-6410