Provider Demographics
NPI:1629787429
Name:PRAISE ABA LLC
Entity Type:Organization
Organization Name:PRAISE ABA LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:VIOLET
Authorized Official - Middle Name:
Authorized Official - Last Name:DEL ROSARIO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:305-799-4542
Mailing Address - Street 1:1030 NE 30TH AVE
Mailing Address - Street 2:
Mailing Address - City:HOMESTEAD
Mailing Address - State:FL
Mailing Address - Zip Code:33033-7608
Mailing Address - Country:US
Mailing Address - Phone:305-799-4542
Mailing Address - Fax:
Practice Address - Street 1:11205 S DIXIE HWY STE 201
Practice Address - Street 2:
Practice Address - City:PINECREST
Practice Address - State:FL
Practice Address - Zip Code:33156-4447
Practice Address - Country:US
Practice Address - Phone:305-799-4542
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-11-21
Last Update Date:2023-02-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior AnalystGroup - Single Specialty