Healthcare Provider Details

I. General information

NPI: 1629787429
Provider Name (Legal Business Name): PRAISE ABA LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/21/2022
Last Update Date: 02/28/2023
Certification Date: 02/28/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

11205 S DIXIE HWY STE 201
PINECREST FL
33156-4447
US

IV. Provider business mailing address

1030 NE 30TH AVE
HOMESTEAD FL
33033-7608
US

V. Phone/Fax

Practice location:
  • Phone: 305-799-4542
  • Fax:
Mailing address:
  • Phone: 305-799-4542
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

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

VIII. Authorized Official

Name: VIOLET DEL ROSARIO
Title or Position: CEO
Credential:
Phone: 305-799-4542