Basic Information
| Provider Information | |||||||||
| NPI: | 1326411968 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | BEHAVIORAL FAMILY SOLUTIONS | ||||||||
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| Mailing Information | |||||||||
| Address1: | 8785 SW 165TH AVE | ||||||||
| Address2: | C-106 | ||||||||
| City: | MIAMI | ||||||||
| State: | FL | ||||||||
| PostalCode: | 331935826 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7863262888 | ||||||||
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| Practice Location | |||||||||
| Address1: | 24885 SW 119TH AVE | ||||||||
| Address2: | |||||||||
| City: | HOMESTEAD | ||||||||
| State: | FL | ||||||||
| PostalCode: | 330324316 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7863262888 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 11/04/2015 | ||||||||
| LastUpdateDate: | 04/13/2016 | ||||||||
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| AuthorizedOfficialLastName: | GONZALEZ | ||||||||
| AuthorizedOfficialFirstName: | SAYLY | ||||||||
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| AuthorizedOfficialTitleorPosition: | LICENSED CLINICAL SOCIAL WORKER/OWN | ||||||||
| AuthorizedOfficialTelephone: | 7863262888 | ||||||||
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| IsOrganizationSubpart: | N | ||||||||
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| AuthorizedOfficialNamePrefix: | MRS. | ||||||||
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| AuthorizedOfficialCredential: | LCSW | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 252Y00000X | SW12880 | FL | N | Agencies | Early Intervention Provider Agency | 103K00000X | SW12880 | FL | N | 193200000X MULTI-SPECIALTY GROUP | Behavioral Health & Social Service Providers | Behavioral Analyst | 251C00000X | SW12886 | FL | N | Agencies | Day Training, Developmentally Disabled Services | 251S00000X | SW12880 | FL | Y | Agencies | Community/Behavioral Health |
No ID Information.