Organization
BACK 2 BASICS BEHAVIORAL MANAGEMENT LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. ALEXIS JOSE MARTINEZ RBT (OWNER)
(786) 447-2555
Entity
Organization
Contact information
Practice address
342 W 37TH ST, HIALEAH, FL 33012-4326
(786) 447-2555
Mailing address
342 W 37TH ST, HIALEAH, FL 33012-4326
(786) 447-2555
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
—
—
106E00000X
Assistant Behavior Analyst
—
—
106S00000X
Behavior Technician
RBT-16-24924
FL
251S00000X
Community/Behavioral Health Agency
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1487019063
NPI
FL
Enumeration date
09/27/2017
Last updated
07/21/2022
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