Provider Demographics
NPI:1437770328
Name:BEHAVIOR CHANGE SOLUTIONS LLC
Entity Type:Organization
Organization Name:BEHAVIOR CHANGE SOLUTIONS LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:BCBA
Authorized Official - Prefix:
Authorized Official - First Name:JENNIFER
Authorized Official - Middle Name:
Authorized Official - Last Name:JONES
Authorized Official - Suffix:
Authorized Official - Credentials:BCBA
Authorized Official - Phone:813-417-6400
Mailing Address - Street 1:16 CALUMET DR
Mailing Address - Street 2:
Mailing Address - City:SAINT JOHNS
Mailing Address - State:FL
Mailing Address - Zip Code:32259-8724
Mailing Address - Country:US
Mailing Address - Phone:813-417-6400
Mailing Address - Fax:
Practice Address - Street 1:16 CALUMET DR
Practice Address - Street 2:
Practice Address - City:SAINT JOHNS
Practice Address - State:FL
Practice Address - Zip Code:32259-8724
Practice Address - Country:US
Practice Address - Phone:813-417-6400
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-05-01
Last Update Date:2020-05-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior AnalystGroup - Single Specialty