Provider Demographics
NPI:1407514805
Name:ABA THERAPY SERVICES INC
Entity Type:Organization
Organization Name:ABA THERAPY SERVICES INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:HUMBERTO
Authorized Official - Middle Name:JESUS
Authorized Official - Last Name:VALLADARES FRAGOSO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:305-301-6937
Mailing Address - Street 1:6425 RED PINE LN APT D
Mailing Address - Street 2:
Mailing Address - City:GREENACRES
Mailing Address - State:FL
Mailing Address - Zip Code:33415-6179
Mailing Address - Country:US
Mailing Address - Phone:305-301-6937
Mailing Address - Fax:
Practice Address - Street 1:6425 RED PINE LN APT D
Practice Address - Street 2:
Practice Address - City:GREENACRES
Practice Address - State:FL
Practice Address - Zip Code:33415-6179
Practice Address - Country:US
Practice Address - Phone:305-301-6937
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-12-02
Last Update Date:2021-12-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior AnalystGroup - Single Specialty