| Dedicated Innovative Behavioral Support | |
|
14325 Tree Swallow Way Lakewood Ranch FL 34202-8296 | |
| (813) 315-5031 | |
| Not Available |
| Full Name | Dedicated Innovative Behavioral Support |
|---|---|
| Speciality | Community/behavioral Health |
| Location | 14325 Tree Swallow Way, Lakewood Ranch, Florida |
| Authorized Official Name and Position | Joshua Kingston (OWNER) |
| Authorized Official Contact | 8133155031 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Dedicated Innovative Behavioral Support 14325 Tree Swallow Way Lakewood Ranch FL 34202-8296 Ph: () - | Dedicated Innovative Behavioral Support 14325 Tree Swallow Way Lakewood Ranch FL 34202-8296 Ph: (813) 315-5031 |
| NPI Number | 1235816083 |
|---|---|
| Provider Enumeration Date | 07/03/2023 |
| Last Update Date | 07/03/2023 |
| Certification Date | 07/03/2023 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1235816083 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 251S00000X | Community/behavioral Health | (* (Not Available)) | Primary |
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