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NPI 1720606460

NPI 1720606460 : RIVER STONE BEHAVIOR LLC : WEST PALM BEACH, FL

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General NPI Number Information
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    NPI Number           |    1720606460
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    Entity Type          |    Organization 
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    Legal Business Name  |    RIVER STONE BEHAVIOR LLC 
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Dates
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    Enumeration Date     |    07/09/2020
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    Last Update Date     |    04/20/2023
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Provider Practice Location Address
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    Address Line         |    1560 WINDORAH WAY APT C 
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    City                 |    WEST PALM BEACH
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    State                |    FL
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    Zip                  |    33411-1987
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    Country              |    US
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    Telephone            |    347-731-2348
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    Fax                  |    
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Provider Business Mailing Address
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    Address Line         |    1560 WINDORAH WAY APT C 
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    City                 |    WEST PALM BEACH
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    State                |    FL
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    Zip                  |    33411-1987
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    Country              |    US
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    Telephone            |    347-731-2348
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    Fax                  |    
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Authorized Official
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    Title or Position    |    CEO
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    Name                 |     KAREN  REYES 
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    Credential           |    BCBA
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    Telephone            |    347-731-2348
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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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