Provider Demographics
NPI:1851000111
Name:BEHAVIORAL SPARK L.L.C
Entity Type:Organization
Organization Name:BEHAVIORAL SPARK L.L.C
Other - Org Name:TRANSFORMING LIVES ABA THERAPY LLC
Other - Org Type:Other Name
Authorized Official - Title/Position:BEHAVIOR ANALYST
Authorized Official - Prefix:
Authorized Official - First Name:MARITZA
Authorized Official - Middle Name:
Authorized Official - Last Name:TORRES
Authorized Official - Suffix:
Authorized Official - Credentials:BCBA
Authorized Official - Phone:305-984-8908
Mailing Address - Street 1:10373 SW 2ND ST
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33174-1704
Mailing Address - Country:US
Mailing Address - Phone:305-984-8908
Mailing Address - Fax:
Practice Address - Street 1:10373 SW 2ND ST
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33174-1704
Practice Address - Country:US
Practice Address - Phone:305-984-8908
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-11-15
Last Update Date:2023-03-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior AnalystGroup - Single Specialty