Healthcare Provider Details

I. General information

NPI: 1134064595
Provider Name (Legal Business Name): THE CHILDREN ABA CENTER LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/22/2026
Last Update Date: 04/30/2026
Certification Date: 04/30/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

130 S INDIAN RIVER DR STE 202-240
FORT PIERCE FL
34950-4343
US

IV. Provider business mailing address

130 S INDIAN RIVER DR STE 202-240
FORT PIERCE FL
34950-4343
US

V. Phone/Fax

Practice location:
  • Phone: 786-681-8494
  • Fax:
Mailing address:
  • Phone: 772-782-4240
  • 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: KEYLLIN ALONSO DELGADO
Title or Position: OWNER
Credential: BCBA
Phone: 772-782-4240