Provider Demographics
NPI:1689272353
Name:INNOVATIVE BEHAVIOR THERAPY SOLUTIONS
Entity Type:Organization
Organization Name:INNOVATIVE BEHAVIOR THERAPY SOLUTIONS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:MICHELLE
Authorized Official - Middle Name:
Authorized Official - Last Name:ADAMS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:941-360-0200
Mailing Address - Street 1:2572 TULIP ST
Mailing Address - Street 2:
Mailing Address - City:SARASOTA
Mailing Address - State:FL
Mailing Address - Zip Code:34239-6335
Mailing Address - Country:US
Mailing Address - Phone:941-266-7326
Mailing Address - Fax:
Practice Address - Street 1:5899 WHITFIELD AVE STE 203
Practice Address - Street 2:
Practice Address - City:SARASOTA
Practice Address - State:FL
Practice Address - Zip Code:34243-6153
Practice Address - Country:US
Practice Address - Phone:941-360-0200
Practice Address - Fax:941-360-0001
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-10-14
Last Update Date:2020-10-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2080P0006XAllopathic & Osteopathic PhysiciansPediatricsDevelopmental - Behavioral PediatricsGroup - Single Specialty