MEDICARE: BETTER DAYS BEHAVIOR SERVICES, 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
1	103K00000X	Behavior Analyst

General Provider Information

NPI Number	:	1528675279
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	BETTER DAYS BEHAVIOR SERVICES, LLC

Provider Business Mailing Address
First Line	:	4013 W SWANN AVE
Second Line	:
City	:	TAMPA
State	:	FL
Zip	:	33609-4434
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	4013 W SWANN AVE
Second Line	:
City	:	TAMPA
State	:	FL
Zip	:	33609-4434
Country	:	US
Telephone Number	:	813-308-9084
Fax Number	:

Authorized Official
Title or Position	:	BOARD CERTIFIED BEHAVIOR ANALYST
Name	:	NICOLE MARIE BALOGH
Credential	:
Telephone Number	:	813-308-9084

Provider Enumeration Date	:	09/27/2020
Last Update Date	:	09/27/2020

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