Provider Demographics
NPI:1740073899
Name:KIDS CORNER BEHAVIOR SERVICES INC
Entity type:Organization
Organization Name:KIDS CORNER BEHAVIOR SERVICES INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:LACEY
Authorized Official - Middle Name:NICOLE
Authorized Official - Last Name:LINAJA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:407-989-4040
Mailing Address - Street 1:311 COMMERCE CENTER DR
Mailing Address - Street 2:
Mailing Address - City:SAINT CLOUD
Mailing Address - State:FL
Mailing Address - Zip Code:34769-1549
Mailing Address - Country:US
Mailing Address - Phone:407-201-6255
Mailing Address - Fax:407-989-4040
Practice Address - Street 1:1975 S JOHN YOUNG PKWY STE 203
Practice Address - Street 2:
Practice Address - City:KISSIMMEE
Practice Address - State:FL
Practice Address - Zip Code:34741-0605
Practice Address - Country:US
Practice Address - Phone:407-201-6255
Practice Address - Fax:407-989-4040
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:KIDS CORNER BEHAVIOR SERVICES INC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2025-05-22
Last Update Date:2025-10-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior AnalystGroup - Multi-Specialty