Healthcare Provider Details
I. General information
NPI: 1063222461
Provider Name (Legal Business Name): ALCANZANDO INC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 01/09/2025
Last Update Date: 01/09/2025
Certification Date: 01/09/2025
Deactivation Date:
Reactivation Date:
III. Provider practice location address
4324 BUTTERFLY ORCHID LN
NAPLES FL
34119-8507
US
IV. Provider business mailing address
4324 BUTTERFLY ORCHID LN
NAPLES FL
34119-8507
US
V. Phone/Fax
- Phone: 239-961-3322
- Fax:
- Phone: 239-961-3322
- 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:
MAPY
CHAVEZ
ASKINS
Title or Position: DIRECTOR
Credential: BCBA-D
Phone: 239-961-3322