Provider Demographics
NPI:1740685833
Name:AHAVA CHRISTIAN COUNSELING AND SERVICES CORP
Entity type:Organization
Organization Name:AHAVA CHRISTIAN COUNSELING AND SERVICES CORP
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:EMILIA
Authorized Official - Middle Name:MORAES
Authorized Official - Last Name:ARNAUD
Authorized Official - Suffix:
Authorized Official - Credentials:PHD
Authorized Official - Phone:954-899-3979
Mailing Address - Street 1:7100 W CAMINO REAL STE 302
Mailing Address - Street 2:
Mailing Address - City:BOCA RATON
Mailing Address - State:FL
Mailing Address - Zip Code:33433-5510
Mailing Address - Country:US
Mailing Address - Phone:954-899-3979
Mailing Address - Fax:
Practice Address - Street 1:7100 WEST CAMINO REAL
Practice Address - Street 2:SUITE 302
Practice Address - City:BOCA RATON
Practice Address - State:FL
Practice Address - Zip Code:33433
Practice Address - Country:US
Practice Address - Phone:954-899-3979
Practice Address - Fax:561-544-2928
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-10-31
Last Update Date:2014-10-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLLCCC06-1960101YP1600X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YP1600XBehavioral Health & Social Service ProvidersCounselorPastoralGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL1483772OtherFLORIDA DEPARTMENT HEALTH DISABILITY