Healthcare Provider Details
I. General information
NPI: 1659016160
Provider Name (Legal Business Name): PL'S BEHAVIOR SERVICES,INC.
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 04/28/2022
Last Update Date: 04/28/2022
Certification Date: 04/28/2022
Deactivation Date:
Reactivation Date:
III. Provider practice location address
263 SAINT THOMAS AVE
KEY LARGO FL
33037-4321
US
IV. Provider business mailing address
263 SAINT THOMAS AVE
KEY LARGO FL
33037-4321
US
V. Phone/Fax
- Phone: 305-879-1389
- Fax:
- Phone: 305-879-1389
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 103K00000X |
| Taxonomy | Behavior Analyst |
| License Number | |
| License Number State | |
| # 2 | |
| Primary Taxonomy | N |
| Taxonomy Code | 106E00000X |
| Taxonomy | Assistant Behavior Analyst |
| License Number | |
| License Number State | |
| # 3 | |
| Primary Taxonomy | N |
| Taxonomy Code | 106S00000X |
| Taxonomy | Behavior Technician |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
LIMAY
PEREZ CHAVIANO
Title or Position: BCBA
Credential: BCBA
Phone: 305-879-1389