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General NPI Number Information
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NPI Number | 1821212754
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Entity Type | Organization
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Legal Business Name | BEHAVIOR SUPPORT SERVICES
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Dates
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Enumeration Date | 04/12/2007
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 10200 SW 120TH ST
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City | MIAMI
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State | FL
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Zip | 33176-4806
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Country | US
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Telephone | 305-259-0501
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Fax | 305-259-0501
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Provider Business Mailing Address
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Address Line | 10200 SW 120TH ST
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City | MIAMI
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State | FL
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Zip | 33176-4806
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Country | US
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Telephone | 305-259-0501
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Fax | 305-259-0501
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Authorized Official
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Title or Position | PRESIDENTOWNER
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Name | MRS. LIUDMILA CARDENASDIAZ
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Credential | BCABA
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Telephone | 305-345-4627
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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 | 0051671
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License Number State | FL
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