Provider Demographics
NPI:1316732019
Name:BEACHSIDE ABA
Entity type:Organization
Organization Name:BEACHSIDE ABA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:BCBA
Authorized Official - Prefix:MR
Authorized Official - First Name:MATT
Authorized Official - Middle Name:
Authorized Official - Last Name:GIULIANO
Authorized Official - Suffix:
Authorized Official - Credentials:BCBA
Authorized Official - Phone:585-402-6340
Mailing Address - Street 1:209 MAPLE DR
Mailing Address - Street 2:
Mailing Address - City:SATELLITE BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:32937-3218
Mailing Address - Country:US
Mailing Address - Phone:585-402-6340
Mailing Address - Fax:
Practice Address - Street 1:209 MAPLE DR
Practice Address - Street 2:
Practice Address - City:SATELLITE BEACH
Practice Address - State:FL
Practice Address - Zip Code:32937-3218
Practice Address - Country:US
Practice Address - Phone:585-402-6340
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-04-12
Last Update Date:2025-04-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior AnalystGroup - Single Specialty