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General NPI Number Information
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NPI Number | 1154622686
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Entity Type | Organization
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Legal Business Name | BEHAVIORS PLUS, INC.
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Dates
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Enumeration Date | 11/15/2010
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Last Update Date | 11/15/2010
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Provider Practice Location Address
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Address Line | 40438 EMERALDA ISLAND RD
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City | LEESBURG
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State | FL
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Zip | 34788-8936
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Country | US
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Telephone | 352-669-3637
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Fax | 352-669-1818
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Provider Business Mailing Address
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Address Line | 40438 EMERALDA ISLAND RD
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City | LEESBURG
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State | FL
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Zip | 34788-8936
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Country | US
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Telephone | 352-669-3637
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Fax | 352-669-1818
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Authorized Official
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Title or Position | OWNER
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Name | JODI SULLIVAN
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Credential |
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Telephone | 352-669-3637
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 320900000X
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Taxonomy Name | Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility
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License Number | 684526696
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License Number State | FL
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