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General NPI Number Information
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NPI Number | 1992233449
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Entity Type | Organization
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Legal Business Name | FULL SPECTRUM INTEGRATED EDUCATIONAL SUPPORT SERVICES, LLC
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Dates
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Enumeration Date | 05/29/2017
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Last Update Date | 07/21/2022
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Provider Practice Location Address
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Address Line | 801 BRICKELL KEY BLVD APT 2007
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City | MIAMI
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State | FL
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Zip | 33131-3718
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Country | US
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Telephone | 561-302-9353
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Fax |
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Provider Business Mailing Address
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Address Line | 801 BRICKELL KEY BLVD APT 2007
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City | MIAMI
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State | FL
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Zip | 33131-3718
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Country | US
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Telephone | 561-302-9353
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | CHLOE CAVAYERO
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Credential | BCBA
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Telephone | 561-302-9353
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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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