Provider Demographics
NPI:1497435333
Name:PIECE BY PIECE ABA THERAPY CORP
Entity Type:Organization
Organization Name:PIECE BY PIECE ABA THERAPY CORP
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:SERGIO
Authorized Official - Middle Name:L
Authorized Official - Last Name:LASTRA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:786-589-3190
Mailing Address - Street 1:5006 TROUBLE CREEK RD STE 229
Mailing Address - Street 2:
Mailing Address - City:NEW PORT RICHEY
Mailing Address - State:FL
Mailing Address - Zip Code:34652-4922
Mailing Address - Country:US
Mailing Address - Phone:786-589-3190
Mailing Address - Fax:
Practice Address - Street 1:5006 TROUBLE CREEK RD STE 229
Practice Address - Street 2:
Practice Address - City:NEW PORT RICHEY
Practice Address - State:FL
Practice Address - Zip Code:34652-4922
Practice Address - Country:US
Practice Address - Phone:786-589-3190
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-07-24
Last Update Date:2023-07-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior AnalystGroup - Single Specialty