Provider Demographics
NPI:1659121994
Name:GULF BREEZE BEHAVIOR ANALYTIC SERVICES AND CONSULTATION LLC
Entity Type:Organization
Organization Name:GULF BREEZE BEHAVIOR ANALYTIC SERVICES AND CONSULTATION LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:LEAD ANALYST
Authorized Official - Prefix:MRS
Authorized Official - First Name:CHELSEA
Authorized Official - Middle Name:SUZANNE
Authorized Official - Last Name:PLANTZ
Authorized Official - Suffix:
Authorized Official - Credentials:BCBA
Authorized Official - Phone:941-626-6644
Mailing Address - Street 1:PO BOX 7393
Mailing Address - Street 2:
Mailing Address - City:NORTH PORT
Mailing Address - State:FL
Mailing Address - Zip Code:34290-0393
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:941-564-7671
Practice Address - Street 1:8721 SAN PABLO AVE
Practice Address - Street 2:
Practice Address - City:NORTH PORT
Practice Address - State:FL
Practice Address - Zip Code:34287-5423
Practice Address - Country:US
Practice Address - Phone:941-626-6644
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-03-26
Last Update Date:2024-03-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior AnalystGroup - Single Specialty