Provider Demographics
NPI:1639413784
Name:LEARNING ALTERNATIVE BEHAVIORS, YOUTH AND FAMILY SERVICES, LLC
Entity Type:Organization
Organization Name:LEARNING ALTERNATIVE BEHAVIORS, YOUTH AND FAMILY SERVICES, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MRS
Authorized Official - First Name:LATOYA
Authorized Official - Middle Name:TOMEKA
Authorized Official - Last Name:BOYD
Authorized Official - Suffix:
Authorized Official - Credentials:LMHC
Authorized Official - Phone:850-509-4825
Mailing Address - Street 1:45 MAKAYLA LN
Mailing Address - Street 2:
Mailing Address - City:QUINCY
Mailing Address - State:FL
Mailing Address - Zip Code:32352-3201
Mailing Address - Country:US
Mailing Address - Phone:850-509-4825
Mailing Address - Fax:
Practice Address - Street 1:11 S CALHOUN ST
Practice Address - Street 2:
Practice Address - City:QUINCY
Practice Address - State:FL
Practice Address - Zip Code:32351-3170
Practice Address - Country:US
Practice Address - Phone:850-627-6220
Practice Address - Fax:850-627-6229
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-11-15
Last Update Date:2013-02-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLMH11334101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessionalGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL768175500Medicaid