Healthcare Provider Details

I. General information

NPI: 1104755750
Provider Name (Legal Business Name): ASHA BEHAVIORAL HEALTH CORP
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/18/2026
Last Update Date: 05/20/2026
Certification Date: 05/20/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1099 W COMMERCE AVE UNIT A
HAINES CITY FL
33844-3272
US

IV. Provider business mailing address

1099 W COMMERCE AVE UNIT A
HAINES CITY FL
33844-3272
US

V. Phone/Fax

Practice location:
  • Phone: 786-265-8088
  • Fax:
Mailing address:
  • Phone:
  • 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: CARLOS SUAREZ
Title or Position: OWNER
Credential:
Phone: 786-265-8088