Provider Demographics
NPI:1013324243
Name:AILATI CORP.
Entity Type:Organization
Organization Name:AILATI CORP.
Other - Org Name:AFSN-CONSULTING
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CHIEF CORDINATING DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:JANNETT
Authorized Official - Middle Name:
Authorized Official - Last Name:PUSEY
Authorized Official - Suffix:
Authorized Official - Credentials:BEHAVIOR THERAPIST
Authorized Official - Phone:305-793-8650
Mailing Address - Street 1:PO BOX 22943
Mailing Address - Street 2:
Mailing Address - City:HIALEAH
Mailing Address - State:FL
Mailing Address - Zip Code:33002-2943
Mailing Address - Country:US
Mailing Address - Phone:888-867-8020
Mailing Address - Fax:305-460-3288
Practice Address - Street 1:301 NW 177TH ST
Practice Address - Street 2:SECOND FLOOR, # 207
Practice Address - City:MIAMI GARDENS
Practice Address - State:FL
Practice Address - Zip Code:33169-4954
Practice Address - Country:US
Practice Address - Phone:888-867-8020
Practice Address - Fax:305-460-3288
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-07-21
Last Update Date:2014-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL730057251C00000X, 253Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care
No251C00000XAgenciesDay Training, Developmentally Disabled Services
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL1659408243OtherVETERAN HOSPITAL MIAMI