Provider Demographics
NPI:1194392514
Name:SIDE BY SIDE BEHAVIORAL HEALTH LLC
Entity Type:Organization
Organization Name:SIDE BY SIDE BEHAVIORAL HEALTH LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:BCBA
Authorized Official - Prefix:
Authorized Official - First Name:PAULA
Authorized Official - Middle Name:
Authorized Official - Last Name:NUNEZ GALETTO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:321-444-9527
Mailing Address - Street 1:2151 CONSULATE DR STE 11
Mailing Address - Street 2:
Mailing Address - City:ORLANDO
Mailing Address - State:FL
Mailing Address - Zip Code:32837-8806
Mailing Address - Country:US
Mailing Address - Phone:321-444-9527
Mailing Address - Fax:407-641-9591
Practice Address - Street 1:2151 CONSULATE DR STE 11
Practice Address - Street 2:
Practice Address - City:ORLANDO
Practice Address - State:FL
Practice Address - Zip Code:32837-8806
Practice Address - Country:US
Practice Address - Phone:321-444-9527
Practice Address - Fax:407-641-9591
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-06-04
Last Update Date:2021-06-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior AnalystGroup - Single Specialty
No106E00000XBehavioral Health & Social Service ProvidersAssistant Behavior AnalystGroup - Single Specialty
No106S00000XBehavioral Health & Social Service ProvidersBehavior TechnicianGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL102758800Medicaid