Healthcare Provider Details

I. General information

NPI: 1174427140
Provider Name (Legal Business Name): PILARES LEGACY BEHAVIORAL SERVICES. LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/05/2026
Last Update Date: 10/05/2026
Certification Date: 09/30/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

706 W 10 TH ST
LEHIGH ACRES FL
33972
US

IV. Provider business mailing address

706 W 10 TH ST
LEHIGH ACRES FL
33972
US

V. Phone/Fax

Practice location:
  • Phone: 615-546-1567
  • Fax:
Mailing address:
  • Phone: 615-546-1567
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103K00000X
TaxonomyBehavior Analyst
License Number
License Number StateNULL

VIII. Authorized Official

Name: MILAGROS PEREZ
Title or Position: OWNER/
Credential:
Phone: 615-546-1567