Provider Demographics
NPI:1417532417
Name:THE INSTITUTE FOR APPLIED BEHAVIOR ANALYSIS
Entity Type:Organization
Organization Name:THE INSTITUTE FOR APPLIED BEHAVIOR ANALYSIS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:MARC
Authorized Official - Middle Name:
Authorized Official - Last Name:TEDOFF
Authorized Official - Suffix:
Authorized Official - Credentials:PHD, BCBA
Authorized Official - Phone:561-401-5163
Mailing Address - Street 1:624 91ST ST
Mailing Address - Street 2:
Mailing Address - City:SURFSIDE
Mailing Address - State:FL
Mailing Address - Zip Code:33154-3131
Mailing Address - Country:US
Mailing Address - Phone:561-401-5163
Mailing Address - Fax:888-688-9464
Practice Address - Street 1:980 N FEDERAL HWY STE 110
Practice Address - Street 2:
Practice Address - City:BOCA RATON
Practice Address - State:FL
Practice Address - Zip Code:33432-2704
Practice Address - Country:US
Practice Address - Phone:561-401-5163
Practice Address - Fax:888-688-9464
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-03-11
Last Update Date:2021-03-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0855XAmbulatory Health Care FacilitiesClinic/CenterAdolescent and Children Mental Health