Healthcare Provider Details

I. General information

NPI: 1548403819
Provider Name (Legal Business Name): BEHAVIORAL LEARNING SYSTEMS, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/15/2009
Last Update Date: 03/07/2022
Certification Date: 03/07/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1408 NW 6TH ST
GAINESVILLE FL
32601-4020
US

IV. Provider business mailing address

1408 NW 6TH ST
GAINESVILLE FL
32601-4020
US

V. Phone/Fax

Practice location:
  • Phone: 352-373-4411
  • Fax: 352-373-4455
Mailing address:
  • Phone: 352-373-4411
  • Fax: 352-373-4455

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code251C00000X
TaxonomyDevelopmentally Disabled Services Day Training Agency
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code251S00000X
TaxonomyCommunity/Behavioral Health Agency
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code252Y00000X
TaxonomyEarly Intervention Provider Agency
License Number
License Number State
# 4
Primary TaxonomyY
Taxonomy Code103K00000X
TaxonomyBehavior Analyst
License Number
License Number State

VIII. Authorized Official

Name: MRS. JANICE GABOURY PULCINI
Title or Position: OWNER/DIRECTOR
Credential: M.A., BCBA
Phone: 352-246-7012