| Behavior Blossoms Llc | |
|
151 W Church Ave Longwood FL 32750-4105 | |
| (407) 342-4220 | |
| Not Available |
| Full Name | Behavior Blossoms Llc |
|---|---|
| Speciality | Behavior Analyst |
| Location | 151 W Church Ave, Longwood, Florida |
| Authorized Official Name and Position | Justin Kindy (CFO) |
| Authorized Official Contact | 4073427939 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Behavior Blossoms Llc 151 W Church Ave Longwood FL 32750-4105 Ph: (407) 342-7939 | Behavior Blossoms Llc 151 W Church Ave Longwood FL 32750-4105 Ph: (407) 342-4220 |
| NPI Number | 1275988412 |
|---|---|
| Provider Enumeration Date | 04/25/2016 |
| Last Update Date | 06/02/2021 |
| Certification Date | 08/31/2020 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1275988412 | NPI | - | NPPES |
| 018050300 | Medicaid | FL |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 103K00000X | Behavior Analyst | 1-13-14275 (Florida) | Primary |
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