Provider Demographics
NPI:1376166280
Name:POSITIVE BEHAVIOR SERVICES, INC
Entity Type:Organization
Organization Name:POSITIVE BEHAVIOR SERVICES, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:REGISTERED BEHAVIORAL THECNICIAN
Authorized Official - Prefix:
Authorized Official - First Name:MISLEYDIS
Authorized Official - Middle Name:
Authorized Official - Last Name:GONZALEZ GARCIA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:786-590-9024
Mailing Address - Street 1:8359 BEACON BLVD STE 416
Mailing Address - Street 2:
Mailing Address - City:FORT MYERS
Mailing Address - State:FL
Mailing Address - Zip Code:33907-3065
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:8359 BEACON BLVD STE 416
Practice Address - Street 2:
Practice Address - City:FORT MYERS
Practice Address - State:FL
Practice Address - Zip Code:33907-3065
Practice Address - Country:US
Practice Address - Phone:800-920-1927
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-05-26
Last Update Date:2020-05-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior AnalystGroup - Single Specialty