Provider Demographics
NPI:1407349111
Name:ADAPT BEHAVIORAL SERVICES
Entity Type:Organization
Organization Name:ADAPT BEHAVIORAL SERVICES
Other - Org Name:APADT BEHAVIORAL
Other - Org Type:Former Legal Business Name
Authorized Official - Title/Position:THERAPIST
Authorized Official - Prefix:MISS
Authorized Official - First Name:LYNNETTE
Authorized Official - Middle Name:
Authorized Official - Last Name:RUIZ
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:407-364-5016
Mailing Address - Street 1:522 VILLA DEL SOL CIR APT 203
Mailing Address - Street 2:
Mailing Address - City:ORLANDO
Mailing Address - State:FL
Mailing Address - Zip Code:32824-9465
Mailing Address - Country:US
Mailing Address - Phone:407-364-5016
Mailing Address - Fax:
Practice Address - Street 1:3483 W VINE ST
Practice Address - Street 2:
Practice Address - City:KISSIMMEE
Practice Address - State:FL
Practice Address - Zip Code:34741-4668
Practice Address - Country:US
Practice Address - Phone:407-928-0444
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-06-08
Last Update Date:2018-06-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL101Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselorGroup - Single Specialty