Provider Demographics
NPI:1689420952
Name:INFINITE BEHAVIOR SOLUTIONS
Entity type:Organization
Organization Name:INFINITE BEHAVIOR SOLUTIONS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:MICHAEL
Authorized Official - Middle Name:WILLIAM
Authorized Official - Last Name:ICE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:321-987-2929
Mailing Address - Street 1:812 KALEY PL
Mailing Address - Street 2:
Mailing Address - City:WEST MELBOURNE
Mailing Address - State:FL
Mailing Address - Zip Code:32904-7319
Mailing Address - Country:US
Mailing Address - Phone:321-987-2929
Mailing Address - Fax:
Practice Address - Street 1:812 KALEY PL
Practice Address - Street 2:
Practice Address - City:WEST MELBOURNE
Practice Address - State:FL
Practice Address - Zip Code:32904-7319
Practice Address - Country:US
Practice Address - Phone:321-987-2929
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-04-27
Last Update Date:2024-04-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior AnalystGroup - Multi-Specialty