Provider Demographics
NPI:1457835415
Name:HOLZ FOUNDATION
Entity Type:Organization
Organization Name:HOLZ FOUNDATION
Other - Org Name:UNIFIED BEHAVIORAL THERAPY, INC.
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OFFICER
Authorized Official - Prefix:
Authorized Official - First Name:JAMES
Authorized Official - Middle Name:
Authorized Official - Last Name:HOLZ
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:321-372-6813
Mailing Address - Street 1:1855 W HIBISCUS BLVD
Mailing Address - Street 2:
Mailing Address - City:MELBOURNE
Mailing Address - State:FL
Mailing Address - Zip Code:32901-2622
Mailing Address - Country:US
Mailing Address - Phone:321-372-6813
Mailing Address - Fax:321-765-6434
Practice Address - Street 1:1855 W HIBISCUS BLVD
Practice Address - Street 2:
Practice Address - City:MELBOURNE
Practice Address - State:FL
Practice Address - Zip Code:32901-2622
Practice Address - Country:US
Practice Address - Phone:321-372-6813
Practice Address - Fax:321-765-6434
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:HOLZ FOUNDATION
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2018-09-17
Last Update Date:2018-09-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior AnalystGroup - Multi-Specialty