| Entity Name: | BRIGHT HORIZONS BEHAVIOR, LLC |
| Jurisdiction: | FLORIDA |
| Filing Type: | Florida Limited Liability Company |
| Status: | Active |
| Date Filed: | 15 Apr 2024 (10 months ago) |
| Document Number: | L24000175635 |
| Address: | 2403 SEASIDE DRIVE, GREENACRES, FL 33463 |
| Mail Address: | 2403 SEASIDE DRIVE, GREENACRES, FL 33463 |
| ZIP code: | 33463 |
| County: | Palm Beach |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1124439344 | 2014-05-09 | 2016-06-24 | BAHIA DEL MAR CIRCLE, 508, SAINT PETERSBURG, FL, 33715, US | 5701 BAHIA DEL MAR CIR, 508, ST PETERSBURG, FL, 337152394, US | |||||||||||||||||||||||
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| Phone | +1 727-278-1171 |
Authorized person
| Name | MR. SPIRO KOTSIOS |
| Role | BCBA/PRESIDENT |
| Phone | 7272781171 |
Taxonomy
| Taxonomy Code | 251S00000X - Community/Behavioral Health Agency |
| License Number | 1-15-18495 |
| State | FL |
| Is Primary | Yes |
Other Provider Identifiers
| Issuer | MEDICAID |
| Number | 010671700 |
| State | FL |
| Name | Role | Address |
|---|---|---|
| HERNANDEZ VALDES, MEILI | Agent | 2403 SEASIDE DRIVE, GREENACRES, FL 33463 |
| Name | Role | Address |
|---|---|---|
| HERNANDEZ VALDES, MEILI | Manager | 2403 SEASIDE DRIVE, GREENACRES, FL 33463 |
| Name | Date |
|---|---|
| Florida Limited Liability | 2024-04-15 |
Date of last update: 08 Feb 2025
Sources: Florida Department of State
