Provider Demographics
NPI:1548849771
Name:BEHAVIOR GAINS LLC
Entity type:Organization
Organization Name:BEHAVIOR GAINS LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:JESSICA
Authorized Official - Middle Name:
Authorized Official - Last Name:SCARDINO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:727-382-0942
Mailing Address - Street 1:1032 E BRANDON BLVD # 4757
Mailing Address - Street 2:
Mailing Address - City:BRANDON
Mailing Address - State:FL
Mailing Address - Zip Code:33511-5509
Mailing Address - Country:US
Mailing Address - Phone:866-277-8884
Mailing Address - Fax:407-789-3156
Practice Address - Street 1:1032 E BRANDON BLVD # 4757
Practice Address - Street 2:
Practice Address - City:BRANDON
Practice Address - State:FL
Practice Address - Zip Code:33511-5509
Practice Address - Country:US
Practice Address - Phone:866-277-8884
Practice Address - Fax:407-789-3156
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-04-05
Last Update Date:2022-12-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior AnalystGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL110133000Medicaid