Provider Demographics
NPI:1821852013
Name:QUALITY LIFE ABA THERAPY LLC
Entity Type:Organization
Organization Name:QUALITY LIFE ABA THERAPY LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:AYLIVE
Authorized Official - Middle Name:
Authorized Official - Last Name:RODRIGUEZ
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:786-236-5144
Mailing Address - Street 1:14250 SW 136TH ST STE 9B
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33186-6718
Mailing Address - Country:US
Mailing Address - Phone:786-599-8169
Mailing Address - Fax:
Practice Address - Street 1:14250 SW 136TH ST STE 9B
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33186-6718
Practice Address - Country:US
Practice Address - Phone:786-599-8169
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-02-08
Last Update Date:2024-02-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior AnalystGroup - Multi-Specialty