Healthcare Provider Details

I. General information

NPI: 1306519491
Provider Name (Legal Business Name): SALAMAN BIRD BEHAVIORAL SERVICES LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/26/2021
Last Update Date: 02/10/2024
Certification Date: 02/10/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2301 13TH ST
SAINT CLOUD FL
34769-4124
US

IV. Provider business mailing address

816 PENNSYLVANIA AVE
SAINT CLOUD FL
34769-3371
US

V. Phone/Fax

Practice location:
  • Phone: 407-452-2536
  • Fax:
Mailing address:
  • Phone: 321-805-4426
  • Fax: 407-902-0019

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103K00000X
TaxonomyBehavior Analyst
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code106E00000X
TaxonomyAssistant Behavior Analyst
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code106S00000X
TaxonomyBehavior Technician
License Number
License Number State

VIII. Authorized Official

Name: MR. HARRY SALAMAN BIRD
Title or Position: OWNER
Credential:
Phone: 407-452-2536