Healthcare Provider Details

I. General information

NPI: 1427528041
Provider Name (Legal Business Name): SIDE BY SIDE BEHAVIORAL HEALTH LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/26/2018
Last Update Date: 11/29/2022
Certification Date: 11/29/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2151 CONSULATE DR STE 11
ORLANDO FL
32837-8806
US

IV. Provider business mailing address

4094 FLORALWOOD CT
ORLANDO FL
32812-7913
US

V. Phone/Fax

Practice location:
  • Phone: 786-797-3207
  • Fax:
Mailing address:
  • Phone: 786-797-3207
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code106E00000X
TaxonomyAssistant Behavior Analyst
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code106S00000X
TaxonomyBehavior Technician
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code261QM0801X
TaxonomyMental Health Clinic/Center (Including Community Mental Health Center)
License Number
License Number State
# 4
Primary TaxonomyY
Taxonomy Code103K00000X
TaxonomyBehavior Analyst
License Number
License Number State

VIII. Authorized Official

Name: PAULA NUNEZ GALETTO
Title or Position: MANAGER
Credential: BCBA
Phone: 312-444-9527