Organization
DEDICATED INNOVATIVE BEHAVIORAL SUPPORT
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JOSHUA KINGSTON (OWNER)
(813) 315-5031
Entity
Organization
Contact information
Practice address
14325 TREE SWALLOW WAY, LAKEWOOD RANCH, FL 34202-8296
(813) 315-5031
Mailing address
14325 TREE SWALLOW WAY, LAKEWOOD RANCH, FL 34202-8296
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
Primary
—
—
Other
Enumeration date
07/03/2023
Last updated
07/03/2023
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