Provider Demographics
NPI:1740792670
Name:BAILES CONSULTING SERVICES
Entity Type:Organization
Organization Name:BAILES CONSULTING SERVICES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:JENNIFER
Authorized Official - Middle Name:
Authorized Official - Last Name:FRETZ-SMITH
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:941-753-3471
Mailing Address - Street 1:PO BOX 5571
Mailing Address - Street 2:
Mailing Address - City:SARASOTA
Mailing Address - State:FL
Mailing Address - Zip Code:34277-5571
Mailing Address - Country:US
Mailing Address - Phone:561-346-3676
Mailing Address - Fax:
Practice Address - Street 1:5150 N TAMIAMI TRL
Practice Address - Street 2:
Practice Address - City:SARASOTA
Practice Address - State:FL
Practice Address - Zip Code:34234-2742
Practice Address - Country:US
Practice Address - Phone:941-753-3471
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-11-01
Last Update Date:2018-06-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL261QD1600X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QD1600XAmbulatory Health Care FacilitiesClinic/CenterDevelopmental Disabilities