Provider Demographics
NPI:1275314510
Name:ROSANA FRIAS LLC
Entity Type:Organization
Organization Name:ROSANA FRIAS LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:ROSANA
Authorized Official - Middle Name:
Authorized Official - Last Name:FRIAS
Authorized Official - Suffix:
Authorized Official - Credentials:BCBA/ISW
Authorized Official - Phone:305-322-3371
Mailing Address - Street 1:8965 NW 144TH TER
Mailing Address - Street 2:
Mailing Address - City:MIAMI LAKES
Mailing Address - State:FL
Mailing Address - Zip Code:33018-7342
Mailing Address - Country:US
Mailing Address - Phone:305-322-3371
Mailing Address - Fax:
Practice Address - Street 1:3901 NW 79TH AVE STE 230
Practice Address - Street 2:
Practice Address - City:DORAL
Practice Address - State:FL
Practice Address - Zip Code:33166-6554
Practice Address - Country:US
Practice Address - Phone:305-322-3371
Practice Address - Fax:786-957-2860
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-10-12
Last Update Date:2024-04-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior AnalystGroup - Multi-Specialty
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Multi-Specialty