Healthcare Provider Details

I. General information

NPI: 1114848447
Provider Name (Legal Business Name): PURE GROWTH BEHAVIORAL SERVICES
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/22/2026
Last Update Date: 07/22/2026
Certification Date: 07/22/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

11886 SW 233RD TER
PRINCETON FL
33032-6080
US

IV. Provider business mailing address

11886 SW 233RD TER
PRINCETON FL
33032-6080
US

V. Phone/Fax

Practice location:
  • Phone: 786-670-5656
  • 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

VIII. Authorized Official

Name: ASHLEY VELEZ
Title or Position: MANAGING MEMBER
Credential: BCBA
Phone: 786-670-5656