Healthcare Provider Details

I. General information

NPI: 1679058903
Provider Name (Legal Business Name): PIVOTAL ACHIEVEMENTS LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/02/2018
Last Update Date: 09/05/2020
Certification Date: 09/05/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7451 WILES RD STE 107
CORAL SPRINGS FL
33067-2040
US

IV. Provider business mailing address

7451 WILES RD STE 107
CORAL SPRINGS FL
33067-2040
US

V. Phone/Fax

Practice location:
  • Phone: 954-893-2442
  • Fax: 954-516-7631
Mailing address:
  • Phone: 954-893-2442
  • Fax: 954-516-7631

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103K00000X
TaxonomyBehavior Analyst
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code106E00000X
TaxonomyAssistant Behavior Analyst
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code106S00000X
TaxonomyBehavior Technician
License Number
License Number State
# 4
Primary TaxonomyN
Taxonomy Code251S00000X
TaxonomyCommunity/Behavioral Health Agency
License Number
License Number State

VIII. Authorized Official

Name: MR. ALEXIE EMIL SABALA
Title or Position: CO-OWNER
Credential: M.ED, BCBA
Phone: 954-893-2442