Healthcare Provider Details

I. General information

NPI: 1144995861
Provider Name (Legal Business Name): LI & R BEHAVIORAL, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/13/2021
Last Update Date: 03/30/2025
Certification Date: 03/30/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

111 E LAKE MARY BLVD STE 113
SANFORD FL
32773-7111
US

IV. Provider business mailing address

1551 SUGARWOOD CIR
WINTER PARK FL
32792-6301
US

V. Phone/Fax

Practice location:
  • Phone: 689-290-2872
  • Fax:
Mailing address:
  • Phone: 786-234-7210
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code252Y00000X
TaxonomyEarly Intervention Provider Agency
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code253Z00000X
TaxonomyIn Home Supportive Care Agency
License Number
License Number State

VIII. Authorized Official

Name: ILEANA FELIPE SANTOS
Title or Position: OWNER
Credential: M. ED., MBA, MS ABA
Phone: 407-906-6558