Provider Demographics
NPI:1447826615
Name:HAWKS NEST BEHAVIORAL SERVICES LLC
Entity type:Organization
Organization Name:HAWKS NEST BEHAVIORAL SERVICES LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:BOARD CERTIFIED BEHAVIOR ANALYST
Authorized Official - Prefix:
Authorized Official - First Name:RICKY
Authorized Official - Middle Name:LAMAR
Authorized Official - Last Name:HAWKS
Authorized Official - Suffix:JR
Authorized Official - Credentials:BCBA
Authorized Official - Phone:407-431-2157
Mailing Address - Street 1:37 N ORANGE AVE STE 500
Mailing Address - Street 2:
Mailing Address - City:ORLANDO
Mailing Address - State:FL
Mailing Address - Zip Code:32801-2438
Mailing Address - Country:US
Mailing Address - Phone:407-431-2157
Mailing Address - Fax:
Practice Address - Street 1:37 N ORANGE AVE STE 500
Practice Address - Street 2:
Practice Address - City:ORLANDO
Practice Address - State:FL
Practice Address - Zip Code:32801-2438
Practice Address - Country:US
Practice Address - Phone:407-431-2157
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-05-28
Last Update Date:2024-02-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior AnalystGroup - Multi-Specialty