Provider Demographics
NPI:1316556533
Name:HI 5 ABA FLORIDA FRANCHISE 5 INC
Entity Type:Organization
Organization Name:HI 5 ABA FLORIDA FRANCHISE 5 INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:STEPHANIE
Authorized Official - Middle Name:
Authorized Official - Last Name:MADDOX
Authorized Official - Suffix:
Authorized Official - Credentials:BCBA
Authorized Official - Phone:571-581-5897
Mailing Address - Street 1:1125 SR A1A
Mailing Address - Street 2:SUITE 306
Mailing Address - City:SATELLITE BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:32937
Mailing Address - Country:US
Mailing Address - Phone:571-581-5897
Mailing Address - Fax:
Practice Address - Street 1:1125 SR A1A
Practice Address - Street 2:SUITE 306
Practice Address - City:SATELLITE BEACH
Practice Address - State:FL
Practice Address - Zip Code:32937
Practice Address - Country:US
Practice Address - Phone:571-581-5897
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-07-23
Last Update Date:2020-07-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior AnalystGroup - Single Specialty