Provider Demographics
NPI:1922788876
Name:POSITIVE BEHAVIOR SUPPORT CORPORATION
Entity Type:Organization
Organization Name:POSITIVE BEHAVIOR SUPPORT CORPORATION
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:BCBA
Authorized Official - Prefix:
Authorized Official - First Name:LAYOTA
Authorized Official - Middle Name:
Authorized Official - Last Name:MAGILL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:855-832-6727
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 1:122 HARLEN DAUGHERTY ST
Practice Address - Street 2:
Practice Address - City:ENGLEWOOD
Practice Address - State:TN
Practice Address - Zip Code:37329-3277
Practice Address - Country:US
Practice Address - Phone:423-920-5211
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-07-24
Last Update Date:2023-07-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior TechnicianGroup - Single Specialty