Organization
BEHAVIOR BLOSSOMS LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JUSTIN KINDY (CFO)
(407) 342-7939
Entity
Organization
Contact information
Practice address
151 W CHURCH AVE, LONGWOOD, FL 32750-4105
(407) 342-4220
Mailing address
151 W CHURCH AVE, LONGWOOD, FL 32750-4105
(407) 342-7939
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
1-13-14275
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
018050300
—
FL
Enumeration date
04/25/2016
Last updated
06/02/2021
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