Provider Demographics
NPI:1649839432
Name:NEW FOUNDATIONS ABA THERAPY, LLC
Entity type:Organization
Organization Name:NEW FOUNDATIONS ABA THERAPY, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/BCBA
Authorized Official - Prefix:
Authorized Official - First Name:ALEXIS
Authorized Official - Middle Name:
Authorized Official - Last Name:BUCASEY-COILE
Authorized Official - Suffix:
Authorized Official - Credentials:BCBA
Authorized Official - Phone:352-321-9100
Mailing Address - Street 1:4327 S HWY 27 # 260
Mailing Address - Street 2:
Mailing Address - City:CLERMONT
Mailing Address - State:FL
Mailing Address - Zip Code:34711-5349
Mailing Address - Country:US
Mailing Address - Phone:352-321-9100
Mailing Address - Fax:352-781-1975
Practice Address - Street 1:4327 S HWY 27 # 260 CLERMONT
Practice Address - Street 2:
Practice Address - City:CLERMONT
Practice Address - State:FL
Practice Address - Zip Code:34711
Practice Address - Country:US
Practice Address - Phone:954-321-9100
Practice Address - Fax:352-781-1975
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-06-06
Last Update Date:2023-11-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes261QD1600XAmbulatory Health Care FacilitiesClinic/CenterDevelopmental Disabilities
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior AnalystGroup - Single Specialty