Provider Demographics
NPI:1518699453
Name:SPRING HEALTH AUTISM INTERVENTION
Entity Type:Organization
Organization Name:SPRING HEALTH AUTISM INTERVENTION
Other - Org Name:SPRING HEALTH AUTISM INTERVENTION
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:YOLANDA
Authorized Official - Middle Name:
Authorized Official - Last Name:DELGADO BAEZ
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:561-406-3040
Mailing Address - Street 1:110 FRONT ST STE 300
Mailing Address - Street 2:
Mailing Address - City:JUPITER
Mailing Address - State:FL
Mailing Address - Zip Code:33477-5095
Mailing Address - Country:US
Mailing Address - Phone:561-406-3040
Mailing Address - Fax:
Practice Address - Street 1:110 FRONT ST STE 300
Practice Address - Street 2:
Practice Address - City:JUPITER
Practice Address - State:FL
Practice Address - Zip Code:33477-5095
Practice Address - Country:US
Practice Address - Phone:561-406-3040
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-06-29
Last Update Date:2022-07-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior AnalystGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL103K00000XMedicaid