Provider Demographics
NPI:1790220465
Name:HOLDING HANDS AUTISM, LLC
Entity Type:Organization
Organization Name:HOLDING HANDS AUTISM, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:FOUNDER/OWNER
Authorized Official - Prefix:
Authorized Official - First Name:STEPHANIE
Authorized Official - Middle Name:
Authorized Official - Last Name:FUENTES
Authorized Official - Suffix:
Authorized Official - Credentials:LMHC
Authorized Official - Phone:305-510-6423
Mailing Address - Street 1:HOLDING HANDS AUTISM, LLC 1870 N CORPORATE LAKES BLVD
Mailing Address - Street 2:UNIT 268672
Mailing Address - City:WESTON
Mailing Address - State:FL
Mailing Address - Zip Code:33326-2184
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:HOLDING HANDS AUTISM, LLC 1870 N CORPORATE LAKES BLVD
Practice Address - Street 2:UNIT 268672
Practice Address - City:WESTON
Practice Address - State:FL
Practice Address - Zip Code:33326-2184
Practice Address - Country:US
Practice Address - Phone:305-510-6423
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-01-04
Last Update Date:2017-02-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLMH10778251S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health