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NPI Code Detail

MEDICARE: BEHAVEABILITY, LLC

MEDICARE: BEHAVEABILITY, 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
1251S00000XCommunity/Behavioral Health Agency2015006474MO

General Provider Information

NPI Number : 1922491737
Entity Type Code : Organization
Provider Name (Legal Business Name) : BEHAVEABILITY, LLC
Provider Business Mailing Address
First Line : 12416 CAPE COD DR
Second Line :
City : SAINT LOUIS
State : MO
Zip : 63146-4624
Country : US
Telephone Number : 314-229-2544
Fax Number :
Provider Business Practice Location Address
First Line : 12416 CAPE COD DR
Second Line :
City : SAINT LOUIS
State : MO
Zip : 63146-4624
Country : US
Telephone Number : 314-229-2544
Fax Number :
Authorized Official
Title or Position : LICENSED BEHAVIOR ANALYST/OWNER
Name : MRS. NICHOLE ANTOINE
Credential : M.S., BCBA, LBA
Telephone Number : 314-229-2544
Provider Enumeration Date : 03/18/2015
Last Update Date : 03/18/2015

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Directions to “BEHAVEABILITY, LLC ” Practice Location

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