Provider Demographics
NPI:1255003026
Name:EQUANIMITY BEHAVIORAL SERVICES CO
Entity Type:Organization
Organization Name:EQUANIMITY BEHAVIORAL SERVICES CO
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:HUMAN RESOURCE DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:KAZMAR
Authorized Official - Middle Name:A
Authorized Official - Last Name:COLE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:305-968-8951
Mailing Address - Street 1:14359 MIRAMAR PKWY # 504
Mailing Address - Street 2:
Mailing Address - City:MIRAMAR
Mailing Address - State:FL
Mailing Address - Zip Code:33027-4134
Mailing Address - Country:US
Mailing Address - Phone:954-399-2637
Mailing Address - Fax:
Practice Address - Street 1:14359 MIRAMAR PKWY # 504
Practice Address - Street 2:
Practice Address - City:MIRAMAR
Practice Address - State:FL
Practice Address - Zip Code:33027-4134
Practice Address - Country:US
Practice Address - Phone:954-399-2637
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-09-30
Last Update Date:2023-09-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistGroup - Multi-Specialty
No235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language PathologistGroup - Multi-Specialty