Provider Demographics
NPI:1598167660
Name:INTEGRAL BEHAVIOR SOLUTIONS CORP
Entity Type:Organization
Organization Name:INTEGRAL BEHAVIOR SOLUTIONS CORP
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MRS
Authorized Official - First Name:SILVIA
Authorized Official - Middle Name:DORA
Authorized Official - Last Name:MACCARI
Authorized Official - Suffix:
Authorized Official - Credentials:BCBA
Authorized Official - Phone:305-244-2514
Mailing Address - Street 1:17720 N BAY RD
Mailing Address - Street 2:AP PH2
Mailing Address - City:SUNNY ISLES BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33160-2881
Mailing Address - Country:US
Mailing Address - Phone:305-932-6287
Mailing Address - Fax:
Practice Address - Street 1:17720 N BAY RD
Practice Address - Street 2:AP PH2
Practice Address - City:SUNNY ISLES BEACH
Practice Address - State:FL
Practice Address - Zip Code:33160-2881
Practice Address - Country:US
Practice Address - Phone:305-932-6287
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-09-20
Last Update Date:2014-09-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL1-14-15728261QM0855X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0855XAmbulatory Health Care FacilitiesClinic/CenterAdolescent and Children Mental Health