Provider Demographics
NPI:1871143982
Name:AVAIL HEALTH AND BEHAVIORAL SOLUTIONS
Entity type:Organization
Organization Name:AVAIL HEALTH AND BEHAVIORAL SOLUTIONS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:AGENCY OWNER
Authorized Official - Prefix:MRS
Authorized Official - First Name:IRISH
Authorized Official - Middle Name:LORRAINE
Authorized Official - Last Name:PORTER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:863-441-3919
Mailing Address - Street 1:545 E TENNESSEE ST STE 100A
Mailing Address - Street 2:
Mailing Address - City:TALLAHASSEE
Mailing Address - State:FL
Mailing Address - Zip Code:32308-4992
Mailing Address - Country:US
Mailing Address - Phone:850-329-2284
Mailing Address - Fax:850-727-8747
Practice Address - Street 1:545 E TENNESSEE ST STE 100A
Practice Address - Street 2:
Practice Address - City:TALLAHASSEE
Practice Address - State:FL
Practice Address - Zip Code:32308-4992
Practice Address - Country:US
Practice Address - Phone:850-329-2284
Practice Address - Fax:850-727-8747
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:AVAIL SERVICES
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2019-09-19
Last Update Date:2020-02-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QD1600XAmbulatory Health Care FacilitiesClinic/CenterDevelopmental Disabilities
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL016810400Medicaid