Provider Demographics
NPI:1104494327
Name:BLUEHEART BEHAVIORAL SERVICES FOR KIDS LLC
Entity type:Organization
Organization Name:BLUEHEART BEHAVIORAL SERVICES FOR KIDS LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:JEANICE
Authorized Official - Middle Name:
Authorized Official - Last Name:GELABERT
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:407-624-5649
Mailing Address - Street 1:3201 BUDINGER AVE
Mailing Address - Street 2:
Mailing Address - City:SAINT CLOUD
Mailing Address - State:FL
Mailing Address - Zip Code:34769-7203
Mailing Address - Country:US
Mailing Address - Phone:407-498-4079
Mailing Address - Fax:407-624-5681
Practice Address - Street 1:3201 BUDINGER AVE
Practice Address - Street 2:
Practice Address - City:SAINT CLOUD
Practice Address - State:FL
Practice Address - Zip Code:34769-7203
Practice Address - Country:US
Practice Address - Phone:407-498-4079
Practice Address - Fax:407-624-5649
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-06-14
Last Update Date:2024-12-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior AnalystGroup - Multi-Specialty