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General NPI Number Information
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NPI Number | 1215450192
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Entity Type | Organization
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Legal Business Name | BEHAVIORAL SOLUTIONS OF NE FL INC
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Dates
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Enumeration Date | 07/21/2017
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Last Update Date | 07/21/2022
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Provider Practice Location Address
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Address Line | 5472 JACKSON AVE
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City | ORANGE PARK
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State | FL
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Zip | 32073-7236
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Country | US
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Telephone | 904-403-1355
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Fax |
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Provider Business Mailing Address
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Address Line | 5472 JACKSON AVE.
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City | ORANGE PARK
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State | FL
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Zip | 32073
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Country | US
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Telephone | 904-403-1355
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | RAYMOND NEAULT
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Credential | FL-CBA
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Telephone | 904-403-1355
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 103K00000X
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Taxonomy Name | Behavior Analyst
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License Number |
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License Number State |
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