Provider Demographics
NPI:1164138277
Name:MISS B'S BEHAVIORAL SERVICES
Entity Type:Organization
Organization Name:MISS B'S BEHAVIORAL SERVICES
Other - Org Name:TARGETED ADVANCE BEHAVIOR SOLUTIONS
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:LATOYA
Authorized Official - Middle Name:M
Authorized Official - Last Name:BULLARD
Authorized Official - Suffix:
Authorized Official - Credentials:BA
Authorized Official - Phone:772-713-4130
Mailing Address - Street 1:4736 34TH AVE
Mailing Address - Street 2:
Mailing Address - City:VERO BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:32967-1234
Mailing Address - Country:US
Mailing Address - Phone:772-584-6227
Mailing Address - Fax:
Practice Address - Street 1:1590 9TH ST SW
Practice Address - Street 2:
Practice Address - City:VERO BEACH
Practice Address - State:FL
Practice Address - Zip Code:32962-4311
Practice Address - Country:US
Practice Address - Phone:772-713-4130
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-01-24
Last Update Date:2023-03-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior AnalystGroup - Single Specialty
No251V00000XAgenciesVoluntary or Charitable
No252Y00000XAgenciesEarly Intervention Provider Agency
No343900000XTransportation ServicesNon-emergency Medical Transport (VAN)Group - Single Specialty