Healthcare Provider Details

I. General information

NPI: 1508520511
Provider Name (Legal Business Name): DAA BEHAVIORAL HEALTH LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/26/2021
Last Update Date: 04/16/2024
Certification Date: 04/16/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6721 ALLEN ST
HOLLYWOOD FL
33024-1807
US

IV. Provider business mailing address

6721 ALLEN ST
HOLLYWOOD FL
33024-1807
US

V. Phone/Fax

Practice location:
  • Phone: 786-805-8076
  • Fax: 786-386-0934
Mailing address:
  • Phone: 786-805-8076
  • Fax: 786-386-0934

VI. Provider taxonomy

Scope of Practice (Provider specialty)

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

VIII. Authorized Official

Name: YUDY AGUILA CUDEIRO
Title or Position: OWNER
Credential: BCBA 1-21-51502
Phone: 786-805-8076