Provider Demographics
NPI:1588179758
Name:ABA LEARNING CENTER LLC
Entity Type:Organization
Organization Name:ABA LEARNING CENTER LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CLINICAL DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:PENELOPE
Authorized Official - Middle Name:
Authorized Official - Last Name:JOHNSON
Authorized Official - Suffix:
Authorized Official - Credentials:BCBA
Authorized Official - Phone:305-902-6435
Mailing Address - Street 1:8603 S DIXIE HWY STE 303
Mailing Address - Street 2:
Mailing Address - City:PINECREST
Mailing Address - State:FL
Mailing Address - Zip Code:33156-1129
Mailing Address - Country:US
Mailing Address - Phone:305-902-6435
Mailing Address - Fax:305-921-9584
Practice Address - Street 1:8603 S DIXIE HWY STE 303
Practice Address - Street 2:
Practice Address - City:PINECREST
Practice Address - State:FL
Practice Address - Zip Code:33156-1129
Practice Address - Country:US
Practice Address - Phone:305-902-6435
Practice Address - Fax:305-921-9584
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-12-09
Last Update Date:2023-10-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health