Healthcare Provider Details
I. General information
NPI: 1790202430
Provider Name (Legal Business Name): 4KIDS ABA THERAPY SERVICES INC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 08/24/2017
Last Update Date: 07/21/2022
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
731 NW 132ND CT
MIAMI FL
33182-2274
US
IV. Provider business mailing address
731 NW 132ND CT
MIAMI FL
33182-2274
US
V. Phone/Fax
- Phone: 786-371-5405
- Fax:
- Phone: 786-371-5405
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | N |
| Taxonomy Code | 251E00000X |
| Taxonomy | Home Health Agency |
| License Number | |
| License Number State | |
| # 2 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 103K00000X |
| Taxonomy | Behavior Analyst |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name: MISS
MARIA
F
PALABEZ
Title or Position: PRESIDENT
Credential:
Phone: 786-371-5405