Organization
HOPE BEHAVIORAL SERVICES OF VOLUSIA LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. WILLIE WALLACE (OWNER/CEO)
(386) 383-4562
Entity
Organization
Contact information
Practice address
210 S BEACH ST STE 200, DAYTONA BEACH, FL 32114-4433
(386) 383-4562
(386) 256-2320
Mailing address
210 S BEACH ST STE 200, DAYTONA BEACH, FL 32114-4433
(386) 383-4562
(386) 256-2320
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
—
—
261Q00000X
Clinic/Center
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
106519500
—
FL
Enumeration date
05/15/2020
Last updated
05/10/2025
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