Provider Demographics
NPI:1225891625
Name:VITA KIDS ABA LLC
Entity Type:Organization
Organization Name:VITA KIDS ABA LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:ISEMILI
Authorized Official - Middle Name:
Authorized Official - Last Name:MURILLO
Authorized Official - Suffix:
Authorized Official - Credentials:BCBA
Authorized Official - Phone:305-336-0683
Mailing Address - Street 1:1251 NW 187TH AVE
Mailing Address - Street 2:
Mailing Address - City:PEMBROKE PINES
Mailing Address - State:FL
Mailing Address - Zip Code:33029-2978
Mailing Address - Country:US
Mailing Address - Phone:305-336-0683
Mailing Address - Fax:
Practice Address - Street 1:1251 NW 187TH AVE
Practice Address - Street 2:
Practice Address - City:PEMBROKE PINES
Practice Address - State:FL
Practice Address - Zip Code:33029-2978
Practice Address - Country:US
Practice Address - Phone:305-336-0683
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-01-30
Last Update Date:2024-01-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior AnalystGroup - Single Specialty