Provider Demographics
NPI:1134901036
Name:BRIGHT MINDS ABA SERVICES CORP
Entity type:Organization
Organization Name:BRIGHT MINDS ABA SERVICES CORP
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:MADELYN
Authorized Official - Middle Name:
Authorized Official - Last Name:ASUAR
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:786-298-9994
Mailing Address - Street 1:1777 TAMIAMI TRL
Mailing Address - Street 2:
Mailing Address - City:PORT CHARLOTTE
Mailing Address - State:FL
Mailing Address - Zip Code:33948-1078
Mailing Address - Country:US
Mailing Address - Phone:786-298-9994
Mailing Address - Fax:
Practice Address - Street 1:1777 TAMIAMI TRL
Practice Address - Street 2:
Practice Address - City:PORT CHARLOTTE
Practice Address - State:FL
Practice Address - Zip Code:33948-1078
Practice Address - Country:US
Practice Address - Phone:786-298-9994
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-10-17
Last Update Date:2023-10-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior AnalystGroup - Multi-Specialty