Provider Demographics
NPI:1144938309
Name:ETERNITY BEHAVIORAL SERVICES
Entity type:Organization
Organization Name:ETERNITY BEHAVIORAL SERVICES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:NEESHAWN
Authorized Official - Middle Name:
Authorized Official - Last Name:FERDINAND
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:407-567-8967
Mailing Address - Street 1:2725 HILLTOP LOOP
Mailing Address - Street 2:
Mailing Address - City:APOPKA
Mailing Address - State:FL
Mailing Address - Zip Code:32712-4802
Mailing Address - Country:US
Mailing Address - Phone:407-567-8967
Mailing Address - Fax:
Practice Address - Street 1:2725 HILLTOP LOOP
Practice Address - Street 2:
Practice Address - City:APOPKA
Practice Address - State:FL
Practice Address - Zip Code:32712-4802
Practice Address - Country:US
Practice Address - Phone:407-567-8967
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-11-07
Last Update Date:2022-11-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior TechnicianGroup - Multi-Specialty
No253Z00000XAgenciesIn Home Supportive CareGroup - Multi-Specialty