Provider Demographics
NPI:1922545490
Name:PREVENTIVE BEHAVIORS & SOLUTIONS INC.
Entity Type:Organization
Organization Name:PREVENTIVE BEHAVIORS & SOLUTIONS INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:VICTORA
Authorized Official - Middle Name:DENISE
Authorized Official - Last Name:WEEKS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:352-874-9802
Mailing Address - Street 1:2475 MARTINS RUN
Mailing Address - Street 2:
Mailing Address - City:TAVARES
Mailing Address - State:FL
Mailing Address - Zip Code:32778-5181
Mailing Address - Country:US
Mailing Address - Phone:352-874-9802
Mailing Address - Fax:352-508-5079
Practice Address - Street 1:2475 MARTINS RUN
Practice Address - Street 2:
Practice Address - City:TAVARES
Practice Address - State:FL
Practice Address - Zip Code:32778-5181
Practice Address - Country:US
Practice Address - Phone:352-874-9802
Practice Address - Fax:352-508-5079
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-01-23
Last Update Date:2017-01-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL000702100251S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health