Provider Demographics
NPI:1174045025
Name:EMERGING INTO NEW BEHAVIOR, INC.
Entity Type:Organization
Organization Name:EMERGING INTO NEW BEHAVIOR, INC.
Other - Org Name:EINB, INC.
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MR
Authorized Official - First Name:PERCY
Authorized Official - Middle Name:
Authorized Official - Last Name:WALKER
Authorized Official - Suffix:JR
Authorized Official - Credentials:
Authorized Official - Phone:561-293-2433
Mailing Address - Street 1:PO BOX 10585
Mailing Address - Street 2:
Mailing Address - City:RIVIERA BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33419-0585
Mailing Address - Country:US
Mailing Address - Phone:561-293-2433
Mailing Address - Fax:561-629-7737
Practice Address - Street 1:2755 BROADWAY
Practice Address - Street 2:
Practice Address - City:RIVIERA BEACH
Practice Address - State:FL
Practice Address - Zip Code:33404-4538
Practice Address - Country:US
Practice Address - Phone:561-293-2433
Practice Address - Fax:561-628-7737
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-07-12
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL5001101YA0400X
FL261QR0405X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes261QR0405XAmbulatory Health Care FacilitiesClinic/CenterRehabilitation, Substance Use Disorder
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)Group - Single Specialty