Provider Demographics
NPI:1073231551
Name:THE PLAY BASE
Entity Type:Organization
Organization Name:THE PLAY BASE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER AND CLINICAL DIRECTOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:FRANCES
Authorized Official - Middle Name:
Authorized Official - Last Name:FISHMAN
Authorized Official - Suffix:
Authorized Official - Credentials:BCBA
Authorized Official - Phone:561-646-9480
Mailing Address - Street 1:22169 CRESSMONT PL
Mailing Address - Street 2:
Mailing Address - City:BOCA RATON
Mailing Address - State:FL
Mailing Address - Zip Code:33428-4280
Mailing Address - Country:US
Mailing Address - Phone:561-646-9480
Mailing Address - Fax:
Practice Address - Street 1:22169 CRESSMONT PL
Practice Address - Street 2:
Practice Address - City:BOCA RATON
Practice Address - State:FL
Practice Address - Zip Code:33428-4280
Practice Address - Country:US
Practice Address - Phone:561-646-9480
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-08-19
Last Update Date:2022-08-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior AnalystGroup - Single Specialty