Provider Demographics
NPI:1790433464
Name:POSTIVE BEHAVIOR SUPPORT CORP
Entity Type:Organization
Organization Name:POSTIVE BEHAVIOR SUPPORT CORP
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:RBT
Authorized Official - Prefix:
Authorized Official - First Name:GRACE
Authorized Official - Middle Name:
Authorized Official - Last Name:REEVES
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:478-697-2093
Mailing Address - Street 1:7108 S KANNER HWY
Mailing Address - Street 2:
Mailing Address - City:STUART
Mailing Address - State:FL
Mailing Address - Zip Code:34997-7462
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:2476 US HIGHWAY 280
Practice Address - Street 2:
Practice Address - City:AILEY
Practice Address - State:GA
Practice Address - Zip Code:30410-3538
Practice Address - Country:US
Practice Address - Phone:404-924-6220
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-03-12
Last Update Date:2022-03-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior TechnicianGroup - Multi-Specialty