Provider Demographics
NPI:1639785645
Name:POSITIVE BEHAVIOR HEALTH DEVELOPMENTS, INC.
Entity Type:Organization
Organization Name:POSITIVE BEHAVIOR HEALTH DEVELOPMENTS, INC.
Other - Org Name:POSITIVE BEHAVIOR HEALTH DEVELOPMENTS, INC.
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CLIENT RELATIONS MANAGER
Authorized Official - Prefix:MR
Authorized Official - First Name:ROSA
Authorized Official - Middle Name:
Authorized Official - Last Name:KUCHLING
Authorized Official - Suffix:
Authorized Official - Credentials:RBT
Authorized Official - Phone:888-343-7222
Mailing Address - Street 1:8270 WOODLAND CENTER BLVD FL 2
Mailing Address - Street 2:
Mailing Address - City:TAMPA
Mailing Address - State:FL
Mailing Address - Zip Code:33614-2401
Mailing Address - Country:US
Mailing Address - Phone:888-343-7222
Mailing Address - Fax:888-791-0181
Practice Address - Street 1:2525 PONCE DE LEON BLVD STE 300
Practice Address - Street 2:
Practice Address - City:CORAL GABLES
Practice Address - State:FL
Practice Address - Zip Code:33134-6044
Practice Address - Country:US
Practice Address - Phone:888-343-7222
Practice Address - Fax:888-791-0181
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:POSITIVE BEHAVIOR HEALTH DEVELOPMENTS, INC.
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2020-09-16
Last Update Date:2022-06-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior AnalystGroup - Multi-Specialty
No106E00000XBehavioral Health & Social Service ProvidersAssistant Behavior AnalystGroup - Multi-Specialty
No106S00000XBehavioral Health & Social Service ProvidersBehavior TechnicianGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL111425200Medicaid