Provider Demographics
NPI:1407557929
Name:POSITIVE BEHAVIOR SUPPORT CORPORATION
Entity Type:Organization
Organization Name:POSITIVE BEHAVIOR SUPPORT CORPORATION
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:REGISTERED BEHAVIOR TECHNICIAN
Authorized Official - Prefix:
Authorized Official - First Name:DENNY
Authorized Official - Middle Name:M
Authorized Official - Last Name:MPULIDO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:321-324-7478
Mailing Address - Street 1:629 YAK CT
Mailing Address - Street 2:
Mailing Address - City:KISSIMMEE
Mailing Address - State:FL
Mailing Address - Zip Code:34759-4327
Mailing Address - Country:US
Mailing Address - Phone:321-324-7478
Mailing Address - Fax:
Practice Address - Street 1:907 OUTER RD STE B
Practice Address - Street 2:
Practice Address - City:ORLANDO
Practice Address - State:FL
Practice Address - Zip Code:32814-6601
Practice Address - Country:US
Practice Address - Phone:833-565-0293
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-03-13
Last Update Date:2023-03-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes305R00000XManaged Care OrganizationsPreferred Provider Organization