Organization
INTEGRATED BEHAVIOR SERVICE INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. MICHAL WALLACE (BCABA)
(305) 213-2845
Entity
Organization
Contact information
Practice address
18751 NW 89TH PL, HIALEAH, FL 33018-6275
(305) 213-2845
(305) 816-0894
Mailing address
18751 NW 89TH PL, HIALEAH, FL 33018-6275
(305) 213-2845
(305) 816-0894
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
Primary
0020585
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
685444396
—
FL
Enumeration date
10/25/2010
Last updated
10/25/2010
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