Provider Demographics
NPI:1649988130
Name:DLAJ BEHAVIOR SERVICES LLC
Entity type:Organization
Organization Name:DLAJ BEHAVIOR SERVICES LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:DIERLYS
Authorized Official - Middle Name:
Authorized Official - Last Name:LOPEZ
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:786-488-8769
Mailing Address - Street 1:3505 NASSAU DR
Mailing Address - Street 2:
Mailing Address - City:MIRAMAR
Mailing Address - State:FL
Mailing Address - Zip Code:33023-6431
Mailing Address - Country:US
Mailing Address - Phone:786-488-8769
Mailing Address - Fax:954-367-5162
Practice Address - Street 1:3505 NASSAU DR
Practice Address - Street 2:
Practice Address - City:MIRAMAR
Practice Address - State:FL
Practice Address - Zip Code:33023-6431
Practice Address - Country:US
Practice Address - Phone:786-488-8769
Practice Address - Fax:954-367-5162
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-11-14
Last Update Date:2022-11-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior AnalystGroup - Multi-Specialty