Healthcare Provider Details

I. General information

NPI: 1912353327
Provider Name (Legal Business Name): PCS & BEHAVIOR SERVICES LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/04/2016
Last Update Date: 05/04/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

93 10TH ST
SAINT CLOUD FL
34769-3901
US

IV. Provider business mailing address

93 10TH ST
SAINT CLOUD FL
34769-3901
US

V. Phone/Fax

Practice location:
  • Phone: 407-764-0285
  • Fax: 407-593-6370
Mailing address:
  • Phone: 407-764-0285
  • Fax: 407-593-6370

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code253Z00000X
TaxonomyIn Home Supportive Care Agency
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code251S00000X
TaxonomyCommunity/Behavioral Health Agency
License Number
License Number State

VIII. Authorized Official

Name: CAROLINA TORUNO
Title or Position: MANAGER
Credential: AGENCY WAIVER PROVID
Phone: 407-764-0285