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NPI Code Detail

MEDICARE: GREAT GAINS BEHAVIORAL SOLUTIONS LLC

MEDICARE: GREAT GAINS 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
1225X00000XOccupational Therapist
2235Z00000XSpeech-Language Pathologist
3225100000XPhysical Therapist
4103K00000XBehavior Analyst

General Provider Information

NPI Number : 1780010520
Entity Type Code : Organization
Provider Name (Legal Business Name) : GREAT GAINS BEHAVIORAL SOLUTIONS LLC
Provider Business Mailing Address
First Line : 40 STATE HIGHWAY 83
Second Line :
City : DEFUNIAK SPRINGS
State : FL
Zip : 32433-7404
Country : US
Telephone Number : 850-585-9189
Fax Number : 850-950-0898
Provider Business Practice Location Address
First Line : 40 STATE HIGHWAY 83
Second Line :
City : DEFUNIAK SPRINGS
State : FL
Zip : 32433-7404
Country : US
Telephone Number : 850-585-9189
Fax Number : 850-951-0898
Authorized Official
Title or Position : PRESIDENT
Name : ANNIE FISCHER
Credential :
Telephone Number : 954-925-3844
Provider Enumeration Date : 09/25/2013
Last Update Date : 08/29/2024

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Directions to “GREAT GAINS BEHAVIORAL SOLUTIONS LLC ” Practice Location

Language Start Address Practice Location
These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

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