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NPI Code Detail

MEDICARE: ACTION BEHAVIOR CENTERS, LLC

MEDICARE: ACTION BEHAVIOR CENTERS, 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
1103K00000XBehavior Analyst

General Provider Information

NPI Number : 1518639210
Entity Type Code : Organization
Provider Name (Legal Business Name) : ACTION BEHAVIOR CENTERS, LLC
Provider Business Mailing Address
First Line : 1601 S MOPAC EXPY
Second Line : SUITE C-300
City : AUSTIN
State : TX
Zip : 78746
Country : US
Telephone Number : 512-920-1239
Fax Number : 512-957-0699
Provider Business Practice Location Address
First Line : 1865 W 121ST AVE STE 200
Second Line :
City : WESTMINSTER
State : CO
Zip : 80234-2337
Country : US
Telephone Number : 720-259-5500
Fax Number : 512-957-0699
Authorized Official
Title or Position : CREDENTIALING MANAGER
Name : SAMANTHA L GOMEZ
Credential :
Telephone Number : 512-551-1717
Provider Enumeration Date : 09/30/2021
Last Update Date : 08/31/2022

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1649986688 — ACTION BEHAVIOR CENTERS, LLC
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Directions to “ACTION BEHAVIOR CENTERS, LLC ” Practice Location

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