Provider Demographics
NPI:1336694827
Name:POSITIVE BEHAVIOR SUPPORTS CORP.
Entity type:Organization
Organization Name:POSITIVE BEHAVIOR SUPPORTS CORP.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:DR
Authorized Official - First Name:MICHAEL
Authorized Official - Middle Name:
Authorized Official - Last Name:NOLAN
Authorized Official - Suffix:
Authorized Official - Credentials:BCBA-D
Authorized Official - Phone:855-832-6727
Mailing Address - Street 1:18846 SW 28TH CT
Mailing Address - Street 2:
Mailing Address - City:MIRAMAR
Mailing Address - State:FL
Mailing Address - Zip Code:33029-2517
Mailing Address - Country:US
Mailing Address - Phone:754-204-2089
Mailing Address - Fax:
Practice Address - Street 1:18846 SW 28TH CT
Practice Address - Street 2:
Practice Address - City:MIRAMAR
Practice Address - State:FL
Practice Address - Zip Code:33029-2517
Practice Address - Country:US
Practice Address - Phone:754-204-2089
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-08-24
Last Update Date:2024-06-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health