Provider Demographics
NPI:1013747591
Name:ELITE SKILLS ABA LLC
Entity type:Organization
Organization Name:ELITE SKILLS ABA LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:RN
Authorized Official - Prefix:
Authorized Official - First Name:LATONIA
Authorized Official - Middle Name:D
Authorized Official - Last Name:COLEMAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:813-394-0902
Mailing Address - Street 1:5130 SABLE CHIME DR
Mailing Address - Street 2:
Mailing Address - City:WIMAUMA
Mailing Address - State:FL
Mailing Address - Zip Code:33598-4170
Mailing Address - Country:US
Mailing Address - Phone:813-394-0902
Mailing Address - Fax:
Practice Address - Street 1:5130 SABLE CHIME DR
Practice Address - Street 2:
Practice Address - City:WIMAUMA
Practice Address - State:FL
Practice Address - Zip Code:33598-4170
Practice Address - Country:US
Practice Address - Phone:813-394-0902
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-08-07
Last Update Date:2024-08-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior AnalystGroup - Single Specialty