Healthcare Provider Details

I. General information

NPI: 1558035766
Provider Name (Legal Business Name): EMBRACE ABA AND SOCIAL CENTER
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/03/2021
Last Update Date: 03/12/2024
Certification Date: 03/12/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

12300 ALTERNATE A1A STE 115
PALM BEACH GARDENS FL
33410-2206
US

IV. Provider business mailing address

5416 WHITE SANDS CV
LAKE WORTH FL
33467-1739
US

V. Phone/Fax

Practice location:
  • Phone: 561-436-9283
  • Fax:
Mailing address:
  • Phone:
  • 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 Code222Q00000X
TaxonomyDevelopmental Therapist
License Number
License Number State
# 4
Primary TaxonomyN
Taxonomy Code261Q00000X
TaxonomyClinic/Center
License Number
License Number State

VIII. Authorized Official

Name: CATHERINE MARTINO FANTAUZZI
Title or Position: BEHAVIOR ANALYST
Credential:
Phone: 561-436-9283