MEDICARE: ONE BEHAVIORAL CARE, LLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy
1	225X00000X	Occupational Therapist
2	235Z00000X	Speech-Language Pathologist
3	252Y00000X	Early Intervention Provider Agency
4	103K00000X	Behavior Analyst

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	61184576	OTHER	FL	TAX ID

General Provider Information

NPI Number	:	1841719291
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	ONE BEHAVIORAL CARE, LLC

Provider Business Mailing Address
First Line	:	1036 QUAIL AVE
Second Line	:
City	:	MIAMI SPRINGS
State	:	FL
Zip	:	33166-3249
Country	:	US
Telephone Number	:	305-321-5578
Fax Number	:

Provider Business Practice Location Address
First Line	:	261 WESTWARD DR STE 201
Second Line	:
City	:	MIAMI SPRINGS
State	:	FL
Zip	:	33166-5208
Country	:	US
Telephone Number	:	305-321-5578
Fax Number	:	305-357-8017

Authorized Official
Title or Position	:	OWNER
Name	:	JOSE SANCHEZ
Credential	:
Telephone Number	:	305-321-5578

Provider Enumeration Date	:	09/18/2017
Last Update Date	:	01/30/2018

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Directions to “ONE BEHAVIORAL CARE, LLC ” Practice Location

Language	Start Address	Practice Location

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