Provider Demographics
NPI:1700457843
Name:WINGS ABA SERVICES LLC
Entity Type:Organization
Organization Name:WINGS ABA SERVICES LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:SILVIA
Authorized Official - Middle Name:
Authorized Official - Last Name:HERNANDEZ
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:786-374-5517
Mailing Address - Street 1:6121 W 24TH AVE APT 209
Mailing Address - Street 2:
Mailing Address - City:HIALEAH GARDENS
Mailing Address - State:FL
Mailing Address - Zip Code:33016-6900
Mailing Address - Country:US
Mailing Address - Phone:786-374-5517
Mailing Address - Fax:561-886-0896
Practice Address - Street 1:6121 W 24TH AVE APT 209
Practice Address - Street 2:
Practice Address - City:HIALEAH GARDENS
Practice Address - State:FL
Practice Address - Zip Code:33016-6900
Practice Address - Country:US
Practice Address - Phone:786-374-5517
Practice Address - Fax:561-886-0896
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-07-09
Last Update Date:2021-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior AnalystGroup - Single Specialty