Provider Demographics
NPI:1609629740
Name:AUTISM ABA CENTER LLC
Entity Type:Organization
Organization Name:AUTISM ABA CENTER LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:KEYLLIN
Authorized Official - Middle Name:
Authorized Official - Last Name:ALONSO DELGADO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:561-609-9054
Mailing Address - Street 1:1221 BRICKELL AVE
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33131-3224
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:1221 BRICKELL AVE
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33131-3224
Practice Address - Country:US
Practice Address - Phone:561-609-9054
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-04-09
Last Update Date:2024-04-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior AnalystGroup - Single Specialty