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General NPI Number Information
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NPI Number | 1295472355
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Entity Type | Organization
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Legal Business Name | EARLY INTERVENTION BEHAVIORAL SERVICES CORP
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Dates
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Enumeration Date | 05/18/2022
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Last Update Date | 04/19/2025
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Provider Practice Location Address
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Address Line | 15936 SW 92ND AVE
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City | PALMETTO BAY
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State | FL
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Zip | 33157-1842
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Country | US
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Telephone | 305-785-9425
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Fax |
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Provider Business Mailing Address
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Address Line | 711 CALATRAVA AVE
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City | CORAL GABLES
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State | FL
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Zip | 33143-6203
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Country | US
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Telephone | 305-785-9425
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | HORACIO ALZATE
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Credential |
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Telephone | 305-788-2849
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251S00000X
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Taxonomy Name | Community/Behavioral Health Agency
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 252Y00000X
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Taxonomy Name | Early Intervention Provider Agency
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License Number |
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License Number State |
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Taxonomy #3
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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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