Basic Information
| Provider Information | |||||||||
| NPI: | 1730517889 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | BEHAVIOR CHANGE INSTITUTE, LLC. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 1200 N WHITE SANDS BLVD STE 115 | ||||||||
| Address2: | |||||||||
| City: | ALAMOGORDO | ||||||||
| State: | NM | ||||||||
| PostalCode: | 883106774 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8662732451 | ||||||||
| FaxNumber: | 8666085560 | ||||||||
| Practice Location | |||||||||
| Address1: | 1200 N WHITE SANDS BLVD STE 115 | ||||||||
| Address2: | |||||||||
| City: | ALAMOGORDO | ||||||||
| State: | NM | ||||||||
| PostalCode: | 883106774 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8662732451 | ||||||||
| FaxNumber: | 8666085560 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 10/29/2013 | ||||||||
| LastUpdateDate: | 10/03/2022 | ||||||||
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| AuthorizedOfficialLastName: | POLLARD | ||||||||
| AuthorizedOfficialFirstName: | JOY | ||||||||
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| AuthorizedOfficialTitleorPosition: | EXECUTIVE DIRECTOR | ||||||||
| AuthorizedOfficialTelephone: | 5754958884 | ||||||||
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| IsOrganizationSubpart: | N | ||||||||
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| AuthorizedOfficialCredential: | PH.D., BCBA-D | ||||||||
| NPICertificationDate: | 09/27/2022 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 251S00000X | Y | Agencies | Community/Behavioral Health |
No ID Information.