Provider Demographics
NPI:1790037844
Name:BEHAVIORAL INTERVENTIONS AND COACHING OF FLORIDA LLC
Entity Type:Organization
Organization Name:BEHAVIORAL INTERVENTIONS AND COACHING OF FLORIDA LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:RHONDA
Authorized Official - Middle Name:
Authorized Official - Last Name:MICHAUD
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:321-693-1969
Mailing Address - Street 1:127 LANCHA CIR
Mailing Address - Street 2:UNIT 203
Mailing Address - City:INDIAN HARBOUR BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:32937-5000
Mailing Address - Country:US
Mailing Address - Phone:321-693-1969
Mailing Address - Fax:
Practice Address - Street 1:127 LANCHA CIR
Practice Address - Street 2:UNIT 203
Practice Address - City:INDIAN HARBOUR BEACH
Practice Address - State:FL
Practice Address - Zip Code:32937-5000
Practice Address - Country:US
Practice Address - Phone:321-693-1969
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-10-12
Last Update Date:2012-10-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLSW57651041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Single Specialty