Provider Demographics
NPI:1073115085
Name:MAS BEHAVIORAL SERVICES
Entity Type:Organization
Organization Name:MAS BEHAVIORAL SERVICES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:BCBA
Authorized Official - Prefix:
Authorized Official - First Name:IVETTE
Authorized Official - Middle Name:MABEL
Authorized Official - Last Name:MAS
Authorized Official - Suffix:
Authorized Official - Credentials:BCBA
Authorized Official - Phone:786-273-6246
Mailing Address - Street 1:18645 SW 291ST ST
Mailing Address - Street 2:
Mailing Address - City:HOMESTEAD
Mailing Address - State:FL
Mailing Address - Zip Code:33030-3056
Mailing Address - Country:US
Mailing Address - Phone:786-273-6246
Mailing Address - Fax:833-326-5080
Practice Address - Street 1:18350 NW 2ND AVE STE 608
Practice Address - Street 2:
Practice Address - City:MIAMI GARDENS
Practice Address - State:FL
Practice Address - Zip Code:33169-4569
Practice Address - Country:US
Practice Address - Phone:786-273-6246
Practice Address - Fax:833-326-5080
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-11-13
Last Update Date:2023-02-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior AnalystGroup - Multi-Specialty