Life Team for Children With Autism

Primary specialty

Behavior AnalystTaxonomy code 103K00000X

Legal business name

LIFE TEAM FOR CHILDREN WITH AUTISM

Practice address

675 Perdido Heights Dr
West Palm Beach, FL 33413-1099

Phone

(386) 290-1602

NPI assigned

Oct 9, 2023

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Mr. Kevin Bernard MooreNPI 1205475951

Title

Owner, Ceo

Phone

(386) 290-1602

Specialties & licenses 1

Addresses

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Kevin Moore

  • Behavior Analyst
  • West Palm Beach, FL
  • NPI 1205475951
  NPD Authorized official

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1696809600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1696809600000",
    "number": "1942081781",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "675 PERDIDO HEIGHTS DR",
            "city": "WEST PALM BEACH",
            "state": "FL",
            "postal_code": "334131099",
            "telephone_number": "386-290-1602"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "675 PERDIDO HEIGHTS DR",
            "city": "WEST PALM BEACH",
            "state": "FL",
            "postal_code": "334131099",
            "telephone_number": "386-290-1602"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LIFE TEAM FOR CHILDREN WITH AUTISM",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-10-09",
        "last_updated": "2023-10-09",
        "certification_date": "2023-10-09",
        "status": "A",
        "authorized_official_last_name": "MOORE",
        "authorized_official_first_name": "KEVIN",
        "authorized_official_middle_name": "BERNARD",
        "authorized_official_title_or_position": "OWNER, CEO",
        "authorized_official_telephone_number": "386-290-1602",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "103K00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Behavior Analyst",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Behavior Analyst in West Palm Beach, FL
• Providers in West Palm Beach, FL by specialty
• Behavior Analyst in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 9, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.