Provider Demographics
NPI:1821705153
Name:SOCIAL DIVERSITY LLC
Entity Type:Organization
Organization Name:SOCIAL DIVERSITY LLC
Other - Org Name:ABA SUNISS UP
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:ESEL
Authorized Official - Middle Name:
Authorized Official - Last Name:AGUILAR
Authorized Official - Suffix:
Authorized Official - Credentials:CBHCMS
Authorized Official - Phone:786-975-7485
Mailing Address - Street 1:382 NE 19TH AVE
Mailing Address - Street 2:
Mailing Address - City:HOMESTEAD
Mailing Address - State:FL
Mailing Address - Zip Code:33033-5265
Mailing Address - Country:US
Mailing Address - Phone:786-975-7485
Mailing Address - Fax:954-860-7166
Practice Address - Street 1:12001 SW 128TH CT STE 101
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33186-4665
Practice Address - Country:US
Practice Address - Phone:786-975-7485
Practice Address - Fax:954-860-7166
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-11-07
Last Update Date:2023-06-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior AnalystGroup - Multi-Specialty