Provider Demographics
NPI:1245747591
Name:THERAPY BA GROUP INC
Entity Type:Organization
Organization Name:THERAPY BA GROUP INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:ELADIO
Authorized Official - Middle Name:JOAQUIN
Authorized Official - Last Name:REINA MENESES
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:786-873-7723
Mailing Address - Street 1:11117 W OKEECHOBEE RD STE 124
Mailing Address - Street 2:
Mailing Address - City:HIALEAH GARDENS
Mailing Address - State:FL
Mailing Address - Zip Code:33018-4210
Mailing Address - Country:US
Mailing Address - Phone:786-873-7723
Mailing Address - Fax:
Practice Address - Street 1:11117 W OKEECHOBEE RD STE 124
Practice Address - Street 2:
Practice Address - City:HIALEAH GARDENS
Practice Address - State:FL
Practice Address - Zip Code:33018-4210
Practice Address - Country:US
Practice Address - Phone:786-873-7723
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-01-09
Last Update Date:2018-01-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior AnalystGroup - Single Specialty