Jaila Greene

Individual provider Active NPI Behavior Technician · Atlantic Beach, FL

NPI 1336979012 · NPPES record last updated Aug 6, 2024

Key facts

NPI
1336979012
Entity type
Individual (NPI type 1)
Primary specialty
Behavior Technician 106S00000X
License
RBT-24-367521 (FL)
Practice address
997 Atlantic Blvd
Atlantic Beach, FL 32233-3311
Phone
(904) 647-1849
Fax
(904) 647-2625
NPI assigned
Aug 6, 2024
Sex
Female
Sole proprietor
No

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No

State licenses

LicenseStateTypeSpecialty
RBT-24-367521FLMDBehavior Technician

Practice roles

OrganizationSpecialtyStatusNew patients
Bloom Behavioral Solutions Current
since Jan 19, 2025
Accepting new patients
Bloom Behavioral Solutions, Inc. Current
since Jan 19, 2025
Accepting new patients

Locations

997 Atlantic Blvd
Jacksonville, FL 32233
Phone (904) 647-1849

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Behavior Technician 106S00000X RBT-24-367521 FL Yes

Addresses

Primary practice location

997 Atlantic Blvd
Atlantic Beach, FL 32233-3311

Mailing address

997 Atlantic Blvd
Atlantic Beach, FL 32233-3311
Phone (904) 647-1849

Other providers in Atlantic Beach, FL

All providers in Atlantic Beach, FL · Behavior Technician in Florida

Sources for this page

Verify at the official NPI Registry.