Provider Demographics
NPI:1336689686
Name:CHILDRENS BEHAVIORAL SERVICES INC
Entity Type:Organization
Organization Name:CHILDRENS BEHAVIORAL SERVICES INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:JESUS
Authorized Official - Middle Name:
Authorized Official - Last Name:QUILES
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:786-200-2726
Mailing Address - Street 1:706 NW 87TH AVE
Mailing Address - Street 2:304
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33172-3418
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:706 NW 87TH AVE
Practice Address - Street 2:304
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33172-3418
Practice Address - Country:US
Practice Address - Phone:786-200-2726
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-03-06
Last Update Date:2017-03-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior AnalystGroup - Multi-Specialty