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General NPI Number Information
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NPI Number | 1922384403
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Entity Type | Organization
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Legal Business Name | BEHAVIOR AND LANGUAGE TREATMENT CENTER
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Dates
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Enumeration Date | 10/27/2011
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Last Update Date | 07/15/2024
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Provider Practice Location Address
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Address Line | 14623 FM 849
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City | LINDALE
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State | TX
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Zip | 75771-2440
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Country | US
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Telephone | 903-520-6243
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Fax | 903-496-0298
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Provider Business Mailing Address
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Address Line | PO BOX 1168
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City | LINDALE
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State | TX
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Zip | 75771-1168
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Country | US
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Telephone | 903-520-6243
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Fax | 903-496-0298
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Authorized Official
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Title or Position | OWNER
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Name | KIMBERLY ELAINE BUTLER
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Credential | RN
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Telephone | 903-520-6243
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251S00000X
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Taxonomy Name | Community/Behavioral Health Agency
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License Number | 629358
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License Number State | TX
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Taxonomy #2
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Taxonomy Code | 251C00000X
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Taxonomy Name | Developmentally Disabled Services Day Training Agency
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License Number | 629358
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License Number State | TX
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