| Boost Behavioral Services Llc | |
|
14b Marshellen Dr Beaufort SC 29902-6900 | |
| (843) 400-4581 | |
| (843) 400-4024 |
| Full Name | Boost Behavioral Services Llc |
|---|---|
| Speciality | Behavior Analyst |
| Location | 14b Marshellen Dr, Beaufort, South Carolina |
| Authorized Official Name and Position | Kelsey Freeze (OWNER) |
| Authorized Official Contact | 9126559431 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Boost Behavioral Services Llc 174 James St Beaufort SC 29902-5324 Ph: (912) 655-9431 | Boost Behavioral Services Llc 14b Marshellen Dr Beaufort SC 29902-6900 Ph: (843) 400-4581 |
| NPI Number | 1912510074 |
|---|---|
| Provider Enumeration Date | 08/28/2020 |
| Last Update Date | 09/24/2020 |
| Certification Date | 09/24/2020 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1912510074 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 103K00000X | Behavior Analyst | (* (Not Available)) | Primary |
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