Provider Demographics
NPI:1528566775
Name:KIDS FOR ABATHERAPY INC
Entity Type:Organization
Organization Name:KIDS FOR ABATHERAPY INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:YOHAN
Authorized Official - Middle Name:U
Authorized Official - Last Name:PENARANDA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:305-252-6783
Mailing Address - Street 1:12039 SW 132ND CT UNIT 28-2
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33186-4785
Mailing Address - Country:US
Mailing Address - Phone:305-252-6783
Mailing Address - Fax:305-252-6784
Practice Address - Street 1:12039 SW 132ND CT UNIT 28-2
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33186-4785
Practice Address - Country:US
Practice Address - Phone:305-252-6783
Practice Address - Fax:305-252-6784
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-01-23
Last Update Date:2018-01-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health