National Provider Identifier Database

ADVANCED BEHAVIORAL CLINICIANS LLC
Family


Contact Information

ADVANCED BEHAVIORAL CLINICIANS, LLC
2650 BAHIA VISTA ST STE 209
SARASOTA, FL34239-2625
Phone: 941-870-3600
Fax: 727-998-8401
Website:
Specialty Taxonomy Code
* Family 363LF0000X
Nurse Practitioner 363L00000X

* Indicates primary specialty

NPI Profile & details for ADVANCED BEHAVIORAL CLINICIANS, LLC

NPI Number 1639793326
Legal business name
LBN
ADVANCED BEHAVIORAL CLINICIANS, LLC
Authorized official ADAIR DEICKE - (OWNER/CEO)
Entity Organization
Organization subpart No
Enumeration date 05/29/2020
Last updated 08/26/2022 - About 4 years ago
Sole proprietor1 Not specified
Identifiers
  • FL Medicaid: 008642300

1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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