Provider Demographics
NPI:1952118101
Name:SFABA UT LLC
Entity type:Organization
Organization Name:SFABA UT LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:YOAD
Authorized Official - Middle Name:
Authorized Official - Last Name:ELMALEH
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:718-722-0269
Mailing Address - Street 1:333 W 41ST ST STE 324
Mailing Address - Street 2:
Mailing Address - City:MIAMI BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33140-3642
Mailing Address - Country:US
Mailing Address - Phone:786-673-9355
Mailing Address - Fax:954-342-6481
Practice Address - Street 1:50 W BROADWAY UNIT 313
Practice Address - Street 2:
Practice Address - City:SALT LAKE CITY
Practice Address - State:UT
Practice Address - Zip Code:84101-2020
Practice Address - Country:US
Practice Address - Phone:786-673-9355
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-12-11
Last Update Date:2024-12-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior AnalystGroup - Multi-Specialty