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NPI Code Detail

MEDICARE: GEORGIA BEHAVIOR ASSOCIATES LLC

MEDICARE: GEORGIA BEHAVIOR ASSOCIATES LLC
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1106E00000XAssistant Behavior Analyst
2251S00000XCommunity/Behavioral Health Agency
3103K00000XBehavior Analyst

General Provider Information

NPI Number : 1033602941
Entity Type Code : Organization
Provider Name (Legal Business Name) : GEORGIA BEHAVIOR ASSOCIATES LLC
Provider Business Mailing Address
First Line : 6214 24TH AVE
Second Line :
City : BROOKLYN
State : NY
Zip : 11204-3319
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 5555 GLENRIDGE CONNECTOR STE 200
Second Line :
City : ATLANTA
State : GA
Zip : 30342-4815
Country : US
Telephone Number : 470-361-2000
Fax Number :
Authorized Official
Title or Position : CEO
Name : ISRAEL BENEDEK
Credential :
Telephone Number : 718-366-6073
Provider Enumeration Date : 06/14/2018
Last Update Date : 07/15/2019

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