Provider Demographics
NPI:1376906909
Name:PRESTON BEHAVIORAL SERVICES LLC
Entity Type:Organization
Organization Name:PRESTON BEHAVIORAL SERVICES LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:APRIL
Authorized Official - Middle Name:S
Authorized Official - Last Name:PRESTON
Authorized Official - Suffix:
Authorized Official - Credentials:MS, BCBA
Authorized Official - Phone:407-624-4002
Mailing Address - Street 1:PO BOX 5348
Mailing Address - Street 2:
Mailing Address - City:WINTER PARK
Mailing Address - State:FL
Mailing Address - Zip Code:32793-5348
Mailing Address - Country:US
Mailing Address - Phone:407-624-4002
Mailing Address - Fax:
Practice Address - Street 1:8123 WHISTLEWING CT
Practice Address - Street 2:
Practice Address - City:ORLANDO
Practice Address - State:FL
Practice Address - Zip Code:32817-1559
Practice Address - Country:US
Practice Address - Phone:407-624-4002
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-03-31
Last Update Date:2016-04-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL1-14-16099103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior AnalystGroup - Single Specialty