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SOUTHLAKE AUTISM AND BEHAVIOR SERVICES PA NPI 1396017414


NPI Information

NPI: 1396017414
Provider Name: SOUTHLAKE AUTISM AND BEHAVIOR SERVICES, PA
Classification: Community/Behavioral Health - 251S00000X
Entity Type: Organization

CLIA Number: 10D2022067

Address:
350 ACCEPTANCE WAY
CLERMONT, FL
ZIP 34711
Phone: (352) 223-1999
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SOUTHLAKE AUTISM AND BEHAVIOR SERVICES, PA is a community behavioral health in Clermont, FL. The provider is a private or public agency usually under local government jurisdiction, responsible for assuring the delivery of community based mental health, intellectual disabilities, substance abuse and/or behavioral health services to individuals with those disabilities. Services may range from companion care, respite, transportation, community integration, crisis intervention and stabilization, supported employment, day support, prevocational services, residential support, therapeutic and supportive consultation, environmental modifications, intensive in-home therapy and day treatment, in addition to traditional mental health and behavioral treatment. SOUTHLAKE AUTISM AND BEHAVIOR SERVICES, PA NPI is 1396017414. The provider is registered as an organization entity type.

The provider's business location address is:

350 ACCEPTANCE WAY
CLERMONT, FL
ZIP 34711
Phone: (352) 223-1999

The provider's authorized official is Terri Howard .
The authorized official title is Clinical Director/behavior Analyst and has the following contact phone number (352) 223-1999.

The CLIA number assigned to this NPI record is 10D2022067 - physician office with a certificate type of Certificate of Compliance.

The enumeration date for this NPI number is 2/5/2012 and was last updated on 5/5/2021.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1251B00000XCase Management0-11-4087FLORIDANo
2251C00000XDay Training, Developmentally Disabled Services0-11-4087FLORIDANo
3251S00000XCommunity/Behavioral Health0-11-4087FLORIDAYes
4252Y00000XEarly Intervention Provider Agency0-11-4087FLORIDANo
5253Z00000XIn Home Supportive Care0-11-4087FLORIDANo

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 5/5/2024

All materials and services on this site are provided on an "as is" and "as available" basis without warranty of any kind. The NPI record is maintained by the National Plan & Provider Enumeration System (NPPES) and anyone may request this information and other NPPES health care provider data from HHS under The Freedom of Information Act (FOIA), Title 5 of the United States Code, section 552. To update the NPI records please contact the NPPES.