Healthcare Provider Details

I. General information

NPI: 1972867802
Provider Name (Legal Business Name): BEHAVIOR & SPEECH INNOVATIONS
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/26/2012
Last Update Date: 06/26/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

206 QUAYSIDE CIR 301
MAITLAND FL
32751-5788
US

IV. Provider business mailing address

PO BOX 2998
WINTER PARK FL
32790-2998
US

V. Phone/Fax

Practice location:
  • Phone: 407-252-4651
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251E00000X
TaxonomyHome Health 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

VIII. Authorized Official

Name: NIKA PALCESKI
Title or Position: MEMBER
Credential:
Phone: 407-252-4651