Organization
SOUTHLAKE AUTISM AND BEHAVIOR SERVICES, PA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. TERRI HOWARD BCBA (CLINICAL DIRECTOR/BEHAVIOR ANALYST)
(352) 223-1999
Entity
Organization
Contact information
Practice address
350 ACCEPTANCE WAY, CLERMONT, FL 34711
(352) 223-1999
Mailing address
13201 SUGARBLUFF RD, CLERMONT, FL 34715-6819
(352) 978-5903
(352) 600-3119
Taxonomy
Speciality
Code
Description
License number
State
251B00000X
Case Management Agency
0-11-4087
FL
251C00000X
Developmentally Disabled Services Day Training Agency
0-11-4087
FL
251S00000X
Community/Behavioral Health Agency
Primary
0-11-4087
FL
252Y00000X
Early Intervention Provider Agency
0-11-4087
FL
253Z00000X
In Home Supportive Care Agency
0-11-4087
FL
Other
Enumeration date
02/05/2012
Last updated
05/05/2021
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