Healthcare Provider Details

I. General information

NPI: 1093413320
Provider Name (Legal Business Name): EMBRACING CHALLENGES SERVICES CORP
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/16/2023
Last Update Date: 04/10/2023
Certification Date: 04/10/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

803 SHOTGUN RD STE 105
SUNRISE FL
33326-1946
US

IV. Provider business mailing address

803 SHOTGUN RD STE 105
SUNRISE FL
33326-1946
US

V. Phone/Fax

Practice location:
  • Phone: 954-618-9996
  • Fax:
Mailing address:
  • Phone: 954-618-9996
  • 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
# 4
Primary TaxonomyN
Taxonomy Code261QM1300X
TaxonomyMulti-Specialty Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: MR. ARLIE PEREZ
Title or Position: CREDENTIALING/BILLING/BCBA
Credential: BCBA
Phone: 954-618-9996