Provider Demographics
NPI:1114550316
Name:LIZT LTM CENTER, INC
Entity Type:Organization
Organization Name:LIZT LTM CENTER, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:LEAD ANALYST
Authorized Official - Prefix:
Authorized Official - First Name:TAMARA
Authorized Official - Middle Name:
Authorized Official - Last Name:COLLADO
Authorized Official - Suffix:
Authorized Official - Credentials:BCBA
Authorized Official - Phone:305-968-3011
Mailing Address - Street 1:100 NE 15TH ST STE 204
Mailing Address - Street 2:
Mailing Address - City:HOMESTEAD
Mailing Address - State:FL
Mailing Address - Zip Code:33030-4576
Mailing Address - Country:US
Mailing Address - Phone:305-968-3011
Mailing Address - Fax:786-701-8538
Practice Address - Street 1:100 NE 15TH ST STE 204
Practice Address - Street 2:
Practice Address - City:HOMESTEAD
Practice Address - State:FL
Practice Address - Zip Code:33030-4576
Practice Address - Country:US
Practice Address - Phone:305-968-3011
Practice Address - Fax:786-701-8538
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-02-15
Last Update Date:2023-03-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior AnalystGroup - Single Specialty