Provider Demographics
NPI:1710222518
Name:BEHAVIORAL AND DEVELOPMENTAL SOLUTIONS
Entity Type:Organization
Organization Name:BEHAVIORAL AND DEVELOPMENTAL SOLUTIONS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OFFICE MANAGER
Authorized Official - Prefix:MRS
Authorized Official - First Name:DORA
Authorized Official - Middle Name:MARIA
Authorized Official - Last Name:GERVASI
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:786-715-6979
Mailing Address - Street 1:381 SW 190TH AVE
Mailing Address - Street 2:
Mailing Address - City:PEMBROKE PINES
Mailing Address - State:FL
Mailing Address - Zip Code:33029-5443
Mailing Address - Country:US
Mailing Address - Phone:786-715-6979
Mailing Address - Fax:
Practice Address - Street 1:381 SW 190TH AVE
Practice Address - Street 2:
Practice Address - City:PEMBROKE PINES
Practice Address - State:FL
Practice Address - Zip Code:33029-5443
Practice Address - Country:US
Practice Address - Phone:786-715-6979
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-12-05
Last Update Date:2012-12-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior AnalystGroup - Single Specialty