Provider Demographics
NPI:1922384403
Name:BEHAVIOR AND LANGUAGE TREATMENT CENTER
Entity type:Organization
Organization Name:BEHAVIOR AND LANGUAGE TREATMENT CENTER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:KIMBERLY
Authorized Official - Middle Name:ELAINE
Authorized Official - Last Name:BUTLER
Authorized Official - Suffix:
Authorized Official - Credentials:RN
Authorized Official - Phone:903-520-6243
Mailing Address - Street 1:PO BOX 1168
Mailing Address - Street 2:
Mailing Address - City:LINDALE
Mailing Address - State:TX
Mailing Address - Zip Code:75771-1168
Mailing Address - Country:US
Mailing Address - Phone:903-520-6243
Mailing Address - Fax:903-496-0298
Practice Address - Street 1:14623 FM 849
Practice Address - Street 2:
Practice Address - City:LINDALE
Practice Address - State:TX
Practice Address - Zip Code:75771-2440
Practice Address - Country:US
Practice Address - Phone:903-520-6243
Practice Address - Fax:903-496-0298
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-10-27
Last Update Date:2024-07-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX629358251S00000X, 251C00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251C00000XAgenciesDay Training, Developmentally Disabled Services
No251S00000XAgenciesCommunity/Behavioral Health