Provider Demographics
NPI:1437934684
Name:UNIVERSE ABA BEHAVIORAL SERVICES
Entity Type:Organization
Organization Name:UNIVERSE ABA BEHAVIORAL SERVICES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:CLARA
Authorized Official - Middle Name:MICAELA
Authorized Official - Last Name:MESA MESA
Authorized Official - Suffix:
Authorized Official - Credentials:RBT
Authorized Official - Phone:786-630-2572
Mailing Address - Street 1:12515 ORANGE DR STE 805
Mailing Address - Street 2:
Mailing Address - City:DAVIE
Mailing Address - State:FL
Mailing Address - Zip Code:33330-4309
Mailing Address - Country:US
Mailing Address - Phone:786-630-2572
Mailing Address - Fax:
Practice Address - Street 1:12515 ORANGE DR STE 805
Practice Address - Street 2:
Practice Address - City:DAVIE
Practice Address - State:FL
Practice Address - Zip Code:33330-4309
Practice Address - Country:US
Practice Address - Phone:786-630-2572
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-08-28
Last Update Date:2023-08-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior AnalystGroup - Multi-Specialty