Provider Demographics
NPI:1629761267
Name:POSITIVE BEHAVIOR SERVICES
Entity Type:Organization
Organization Name:POSITIVE BEHAVIOR SERVICES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:REGISTER BEHAVIOR TECHNICIAN
Authorized Official - Prefix:
Authorized Official - First Name:LETYRA
Authorized Official - Middle Name:TIMAE
Authorized Official - Last Name:WILSON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:786-366-5453
Mailing Address - Street 1:18940 NW 27TH AVE APT 202
Mailing Address - Street 2:
Mailing Address - City:MIAMI GARDENS
Mailing Address - State:FL
Mailing Address - Zip Code:33056-2516
Mailing Address - Country:US
Mailing Address - Phone:786-366-5453
Mailing Address - Fax:
Practice Address - Street 1:18940 NW 27TH AVE APT 202
Practice Address - Street 2:
Practice Address - City:MIAMI GARDENS
Practice Address - State:FL
Practice Address - Zip Code:33056-2516
Practice Address - Country:US
Practice Address - Phone:786-366-5453
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-05-30
Last Update Date:2023-05-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior TechnicianGroup - Single Specialty