Provider Demographics
NPI:1396423133
Name:ADVANTEDGE CARE BEHAVIOR GROUP LLC
Entity type:Organization
Organization Name:ADVANTEDGE CARE BEHAVIOR GROUP LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:YENY
Authorized Official - Middle Name:
Authorized Official - Last Name:MILA RAMOS
Authorized Official - Suffix:
Authorized Official - Credentials:BCBA
Authorized Official - Phone:305-308-6519
Mailing Address - Street 1:1555 W 44TH PL
Mailing Address - Street 2:APT 214
Mailing Address - City:HIALEAH
Mailing Address - State:FL
Mailing Address - Zip Code:33012
Mailing Address - Country:US
Mailing Address - Phone:305-308-6519
Mailing Address - Fax:
Practice Address - Street 1:12461 SW 130TH ST STE B7
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33186-6235
Practice Address - Country:US
Practice Address - Phone:305-308-6519
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-07-11
Last Update Date:2024-01-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior AnalystGroup - Single Specialty