MEDICARE: POSITIVE BEHAVIORAL SOLUTIONS LLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	251S00000X	Community/Behavioral Health Agency	MH9810	FL

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1669898136
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	POSITIVE BEHAVIORAL SOLUTIONS LLC

Provider Business Mailing Address
First Line	:	2646 BENT HICKORY CIR
Second Line	:
City	:	LONGWOOD
State	:	FL
Zip	:	32779-3665
Country	:	US
Telephone Number	:	407-222-5968
Fax Number	:

Provider Business Practice Location Address
First Line	:	7635 ASHLEY PARK CT
Second Line	:	SUITE 503-H
City	:	ORLANDO
State	:	FL
Zip	:	32835-6195
Country	:	US
Telephone Number	:	407-222-5968
Fax Number	:

Authorized Official
Title or Position	:	OWNER
Name	:	TRACY SABAS RAMOS
Credential	:	LMHC
Telephone Number	:	407-222-5968

Provider Enumeration Date	:	03/08/2014
Last Update Date	:	03/08/2014

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