Provider Demographics
NPI:1184483448
Name:LV KIDS BEHAVIOR INC
Entity type:Organization
Organization Name:LV KIDS BEHAVIOR INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:LISNET
Authorized Official - Middle Name:
Authorized Official - Last Name:ROSSEL HERRADA
Authorized Official - Suffix:
Authorized Official - Credentials:BCBA
Authorized Official - Phone:305-833-8477
Mailing Address - Street 1:2810 E OAKLAND PARK BLVD STE 200-10
Mailing Address - Street 2:
Mailing Address - City:FORT LAUDERDALE
Mailing Address - State:FL
Mailing Address - Zip Code:33306-1801
Mailing Address - Country:US
Mailing Address - Phone:305-833-8477
Mailing Address - Fax:
Practice Address - Street 1:2810 E OAKLAND PARK BLVD STE 200-10
Practice Address - Street 2:
Practice Address - City:FORT LAUDERDALE
Practice Address - State:FL
Practice Address - Zip Code:33306-1801
Practice Address - Country:US
Practice Address - Phone:305-833-8477
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-03-18
Last Update Date:2024-03-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior AnalystGroup - Multi-Specialty