Provider Demographics
NPI:1720254501
Name:SOUTH FLORIDA BEHAVIORAL SERVICES, INC.
Entity Type:Organization
Organization Name:SOUTH FLORIDA BEHAVIORAL SERVICES, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:BEHAVIOR ANALYST
Authorized Official - Prefix:MRS
Authorized Official - First Name:NATALIE
Authorized Official - Middle Name:LODES
Authorized Official - Last Name:BREMSON
Authorized Official - Suffix:
Authorized Official - Credentials:BCBA
Authorized Official - Phone:954-290-3633
Mailing Address - Street 1:50 TORCHWOOD AVE
Mailing Address - Street 2:
Mailing Address - City:PLANTATION
Mailing Address - State:FL
Mailing Address - Zip Code:33324-2317
Mailing Address - Country:US
Mailing Address - Phone:954-290-3633
Mailing Address - Fax:888-407-7512
Practice Address - Street 1:50 TORCHWOOD AVE
Practice Address - Street 2:
Practice Address - City:PLANTATION
Practice Address - State:FL
Practice Address - Zip Code:33324-2317
Practice Address - Country:US
Practice Address - Phone:954-290-3633
Practice Address - Fax:888-407-7512
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-05-01
Last Update Date:2016-11-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes251S00000XAgenciesCommunity/Behavioral Health
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior AnalystGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL693605996Medicaid
FL693605998Medicaid