Healthcare Provider Details

I. General information

NPI: 1316684277
Provider Name (Legal Business Name): CAAN BEHAVIORAL SERVICES LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/12/2022
Last Update Date: 05/12/2022
Certification Date: 05/12/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

22731 SW 88TH PL UNIT 203
CUTLER BAY FL
33190-2025
US

IV. Provider business mailing address

22731 SW 88TH PL UNIT 203
CUTLER BAY FL
33190-2025
US

V. Phone/Fax

Practice location:
  • Phone: 786-543-6463
  • Fax:
Mailing address:
  • Phone: 786-543-6463
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103K00000X
TaxonomyBehavior Analyst
License Number
License Number State

VIII. Authorized Official

Name: ARMANDO GUTIERREZ LEDESMA
Title or Position: OWNER
Credential:
Phone: 786-853-7738