Healthcare Provider Details

I. General information

NPI: 1659125698
Provider Name (Legal Business Name): ABA AND MENTAL HEALTH SERVICES LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/16/2024
Last Update Date: 10/08/2026
Certification Date: 10/08/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

12905 SW 42ND ST STE 207
MIAMI FL
33175-2912
US

IV. Provider business mailing address

12905 SW 42ND ST STE 207 STE 207
MIAMI FL
33175-2912
US

V. Phone/Fax

Practice location:
  • Phone: 786-800-4147
  • Fax:
Mailing address:
  • Phone: 786-579-1966
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

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

VIII. Authorized Official

Name: ILIEVA V VALDES
Title or Position: PRESIDENT
Credential:
Phone: 305-910-7566