Provider Demographics
NPI:1053052555
Name:ABA ASSISTANCE CORP
Entity Type:Organization
Organization Name:ABA ASSISTANCE CORP
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:HALIANY
Authorized Official - Middle Name:
Authorized Official - Last Name:PRUNA DIAZ
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:786-878-0474
Mailing Address - Street 1:116 SOFIA LN
Mailing Address - Street 2:
Mailing Address - City:LAKE ALFRED
Mailing Address - State:FL
Mailing Address - Zip Code:33850-2552
Mailing Address - Country:US
Mailing Address - Phone:786-878-0474
Mailing Address - Fax:
Practice Address - Street 1:116 SOFIA LN
Practice Address - Street 2:
Practice Address - City:LAKE ALFRED
Practice Address - State:FL
Practice Address - Zip Code:33850-2552
Practice Address - Country:US
Practice Address - Phone:786-878-0474
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-04-06
Last Update Date:2022-04-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health