Blue Wave Behavioral Serivces

LBN: Blue Wave Behavioral Serivces
Blue Wave Behavioral Serivces is an health care organization with primary practice located at 1482 Premier Village Way Fl Usa , Clearwater FL 33764-2885. The organization recently has only one registered license in Behavioral Health & Social Service Providers / Behavioral Analyst, which is considered as the primary health care specialty. Blue Wave Behavioral Serivces can be contacted via phone (727) 278-6765, or through Wixon, Jennifer via phone (727) 278-6765.

Contact Information

Primary practice address
1482 Premier Village Way Fl Usa Clearwater FL 33764-2885
Phone: (727) 278-6765
Fax:
Website:
Map and Directions
Authorized official contact:
Name: Wixon, Jennifer BCBA
Phone: (727) 278-6765

Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / Behavioral Analyst 103K00000X

Profile Details

NPI number 1295443224
LBN Legal business name Blue Wave Behavioral Serivces
DBA Doing business as
Authorized official Wixon, Jennifer BCBA
Entity Organization
Organization subpart 1 No
Enumeration date Nov 8th, 2022
Last updated Nov 8th, 2022 - about 3 years ago

1 Some organizations, which are providing health care services, may consist of units or departments that provide different types of health care services or have several separate physical locations, where health care service is provided. These units, departments or physical locations are not themselves legal entities. However, each of them is part of the organization, which is a legal entity. The organization may decide whether its subparts, if it has any, should have their own NPI numbers. In case a subpart conducts any HIPAA standard transactions by itself, without its parent's involvement, it must have its own NPI number.

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Identifiers

StateTypeNumberIssuer
All States NPI 1295443224 NPPES
Florida MEDICAID 110767000

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