Provider Demographics
NPI:1598311722
Name:ADVANCED BEHAVIORAL DIMENSIONS
Entity Type:Organization
Organization Name:ADVANCED BEHAVIORAL DIMENSIONS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:ZENAYDA
Authorized Official - Middle Name:
Authorized Official - Last Name:LA FONTAINE
Authorized Official - Suffix:
Authorized Official - Credentials:BCBA
Authorized Official - Phone:786-447-0022
Mailing Address - Street 1:9241 SW 212TH TER
Mailing Address - Street 2:
Mailing Address - City:CUTLER BAY
Mailing Address - State:FL
Mailing Address - Zip Code:33189-3833
Mailing Address - Country:US
Mailing Address - Phone:786-447-0022
Mailing Address - Fax:
Practice Address - Street 1:9241 SW 212TH TER
Practice Address - Street 2:
Practice Address - City:CUTLER BAY
Practice Address - State:FL
Practice Address - Zip Code:33189-3833
Practice Address - Country:US
Practice Address - Phone:786-447-0022
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-08-13
Last Update Date:2023-03-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior AnalystGroup - Single Specialty