Provider Demographics
NPI:1851152433
Name:VERDASCO BEHAVIOR SERVICES LLC
Entity Type:Organization
Organization Name:VERDASCO BEHAVIOR SERVICES LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:REGISTERED BEHAVIOR TECHNICIAN
Authorized Official - Prefix:MS
Authorized Official - First Name:LIANETT
Authorized Official - Middle Name:
Authorized Official - Last Name:VERDASCO CRUZ
Authorized Official - Suffix:
Authorized Official - Credentials:RBT-16-16598
Authorized Official - Phone:786-547-2411
Mailing Address - Street 1:10358 NW 35TH AVE
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33147-1014
Mailing Address - Country:US
Mailing Address - Phone:786-547-2411
Mailing Address - Fax:
Practice Address - Street 1:10358 NW 35TH AVE
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33147-1014
Practice Address - Country:US
Practice Address - Phone:786-547-2411
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-01-19
Last Update Date:2024-01-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior TechnicianGroup - Single Specialty