| Blue Iris Behavioral Services Corp | |
|
4640 Lipscomb St Ne Ste 4 Palm Bay FL 32905-2986 | |
| (321) 537-4467 | |
| Not Available |
| Full Name | Blue Iris Behavioral Services Corp |
|---|---|
| Speciality | Behavior Analyst |
| Location | 4640 Lipscomb St Ne Ste 4, Palm Bay, Florida |
| Authorized Official Name and Position | Diliana B Polanco (PRESIDENT) |
| Authorized Official Contact | 3215374467 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Blue Iris Behavioral Services Corp 4640 Lipscomb St Ne Ste 4 Palm Bay FL 32905-2986 Ph: (321) 537-4467 | Blue Iris Behavioral Services Corp 4640 Lipscomb St Ne Ste 4 Palm Bay FL 32905-2986 Ph: (321) 537-4467 |
| NPI Number | 1023777935 |
|---|---|
| Provider Enumeration Date | 12/08/2021 |
| Last Update Date | 12/08/2021 |
| Certification Date | 12/08/2021 |
| Medicare PECOS PAC ID | 5395129209 |
|---|---|
| Medicare Enrollment ID | O20220826000278 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1023777935 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 103K00000X | Behavior Analyst | (* (Not Available)) | Primary |
| Provider Name | Diliana Polanco |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1477018331 PECOS PAC ID: 9830511724 Enrollment ID: I20200623001307 |
Abundant Life Centers Llc Mental Health Clinic Medicare: Medicare Enrolled Practice Location: 2475 Palm Bay Rd Ne Ste 145-23, Palm Bay, FL 32905 Phone: 321-345-6831 | |
Socially Significant Applied Behavior Analysis Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 148 Feldman St Se, Palm Bay, FL 32909 Phone: 321-750-9803 | |
Making Strides Aba Therapy Llc Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 4651 Babcock St Ne, Ste 18, Palm Bay, FL 32905 Phone: 321-338-3936 | |
Bayside Family Counseling Llc Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 1890 Hallendale Ave Sw, Palm Bay, FL 32908 Phone: 321-616-5727 | |
Bayside Recovery And Wellness Center Llc Mental Health Clinic Medicare: Medicare Enrolled Practice Location: 1501 Robert J Conlan Blvd Ne Ste 7, Palm Bay, FL 32905 Phone: 321-372-6897 Fax: 321-372-6896 | |
Stellarsteps Aba Llc Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 290 Hammock Rd Se, Palm Bay, FL 32909 Phone: 321-312-7532 |