Provider Demographics
NPI:1417656307
Name:BLUE PARADISE ABA LLC
Entity Type:Organization
Organization Name:BLUE PARADISE ABA LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:DAYMA
Authorized Official - Middle Name:
Authorized Official - Last Name:ALOMA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:786-360-4328
Mailing Address - Street 1:5941 NW 173RD DR UNIT B6
Mailing Address - Street 2:
Mailing Address - City:HIALEAH
Mailing Address - State:FL
Mailing Address - Zip Code:33015-5109
Mailing Address - Country:US
Mailing Address - Phone:786-360-4328
Mailing Address - Fax:786-409-7369
Practice Address - Street 1:5941 NW 173RD DR UNIT B6
Practice Address - Street 2:
Practice Address - City:HIALEAH
Practice Address - State:FL
Practice Address - Zip Code:33015-5109
Practice Address - Country:US
Practice Address - Phone:786-360-4328
Practice Address - Fax:786-409-7369
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-02-28
Last Update Date:2023-02-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior AnalystGroup - Single Specialty