Provider Demographics
NPI:1245748177
Name:ADVANCED BEHAVIORAL ALLIANCE CORP
Entity type:Organization
Organization Name:ADVANCED BEHAVIORAL ALLIANCE CORP
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:JULIO
Authorized Official - Middle Name:C
Authorized Official - Last Name:DELGADO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:305-702-1594
Mailing Address - Street 1:1221 SW 27TH AVE STE 302
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33135-4759
Mailing Address - Country:US
Mailing Address - Phone:786-374-7374
Mailing Address - Fax:305-851-0020
Practice Address - Street 1:1221 SW 27TH AVE STE 302
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33135-4759
Practice Address - Country:US
Practice Address - Phone:786-374-7374
Practice Address - Fax:305-851-0020
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-01-12
Last Update Date:2024-10-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior AnalystGroup - Single Specialty