Provider Demographics
NPI:1821800400
Name:ABA CENTERS OF PUERTO RICO LLC
Entity type:Organization
Organization Name:ABA CENTERS OF PUERTO RICO LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:VP OF RCM
Authorized Official - Prefix:
Authorized Official - First Name:JOCELYN
Authorized Official - Middle Name:
Authorized Official - Last Name:MIKAIL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:718-844-8757
Mailing Address - Street 1:4620 N STATE ROAD 7 STE 300
Mailing Address - Street 2:
Mailing Address - City:LAUDERDALE LAKES
Mailing Address - State:FL
Mailing Address - Zip Code:33319-5867
Mailing Address - Country:US
Mailing Address - Phone:561-323-6582
Mailing Address - Fax:561-997-1246
Practice Address - Street 1:METRO PARQUE 7, STREET # 1, SUITE 204
Practice Address - Street 2:
Practice Address - City:GUAYNABO, SAN JUAN
Practice Address - State:PR
Practice Address - Zip Code:00968
Practice Address - Country:US
Practice Address - Phone:613-236-5825
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-01-22
Last Update Date:2025-03-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior AnalystGroup - Single Specialty