Healthcare Provider Details

I. General information

NPI: 1942872007
Provider Name (Legal Business Name): ATH BEHAVIORAL SERVICES, 'LLC'
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/16/2021
Last Update Date: 10/13/2025
Certification Date: 10/13/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3325 HOLLYWOOD BLVD STE 502
HOLLYWOOD FL
33021-6921
US

IV. Provider business mailing address

3325 HOLLYWOOD BLVD STE 502
HOLLYWOOD FL
33021-6921
US

V. Phone/Fax

Practice location:
  • Phone: 954-544-5181
  • Fax:
Mailing address:
  • Phone: 954-544-5181
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103K00000X
TaxonomyBehavior Analyst
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code261QD1600X
TaxonomyDevelopmental Disabilities Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: ZAIRA C DUARTE
Title or Position: CEO
Credential:
Phone: 786-308-6353