Healthcare Provider Details

I. General information

NPI: 1427618503
Provider Name (Legal Business Name): EVERYTHING ABA LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/19/2019
Last Update Date: 06/19/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

221 STRAWBERRY OAKS DR STE 1000
ORANGE CITY FL
32763-7456
US

IV. Provider business mailing address

221 STRAWBERRY OAKS DR STE 1000
ORANGE CITY FL
32763-7456
US

V. Phone/Fax

Practice location:
  • Phone: 386-717-0262
  • Fax:
Mailing address:
  • Phone: 386-717-0262
  • 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 Code106E00000X
TaxonomyAssistant Behavior Analyst
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code106S00000X
TaxonomyBehavior Technician
License Number
License Number State

VIII. Authorized Official

Name: KWANA JACOBS
Title or Position: DIRECTOR
Credential:
Phone: 386-717-0262