Provider Demographics
NPI:1164283776
Name:SUNFLOWER ABA LLC
Entity Type:Organization
Organization Name:SUNFLOWER ABA LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:LISBEYDI
Authorized Official - Middle Name:
Authorized Official - Last Name:MADRIGAL BARCELO
Authorized Official - Suffix:
Authorized Official - Credentials:BCBA
Authorized Official - Phone:561-541-6372
Mailing Address - Street 1:2149 SW FEARS AVE
Mailing Address - Street 2:
Mailing Address - City:PORT SAINT LUCIE
Mailing Address - State:FL
Mailing Address - Zip Code:34953-4533
Mailing Address - Country:US
Mailing Address - Phone:561-541-6372
Mailing Address - Fax:772-353-5131
Practice Address - Street 1:2149 SW FEARS AVE
Practice Address - Street 2:
Practice Address - City:PORT SAINT LUCIE
Practice Address - State:FL
Practice Address - Zip Code:34953-4533
Practice Address - Country:US
Practice Address - Phone:561-541-6372
Practice Address - Fax:772-353-5131
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-01-22
Last Update Date:2024-01-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior AnalystGroup - Multi-Specialty