Provider Demographics
NPI:1518630508
Name:COLORFUL SMILE BEHAVIORAL & HOME SERVICES INC.
Entity type:Organization
Organization Name:COLORFUL SMILE BEHAVIORAL & HOME SERVICES INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:RICHARD
Authorized Official - Middle Name:
Authorized Official - Last Name:RAMOS HERNANDEZ
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:786-439-5707
Mailing Address - Street 1:5725 CORPORATE WAY STE 207
Mailing Address - Street 2:
Mailing Address - City:WEST PALM BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33407-2035
Mailing Address - Country:US
Mailing Address - Phone:561-484-5552
Mailing Address - Fax:
Practice Address - Street 1:5725 CORPORATE WAY STE 207
Practice Address - Street 2:
Practice Address - City:WEST PALM BEACH
Practice Address - State:FL
Practice Address - Zip Code:33407-2035
Practice Address - Country:US
Practice Address - Phone:561-806-1798
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-07-27
Last Update Date:2021-08-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior AnalystGroup - Multi-Specialty