Healthcare Provider Details

I. General information

NPI: 1447717343
Provider Name (Legal Business Name): ENDLESS POSSIBILITIES THERAPY AND LEARNING LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/27/2019
Last Update Date: 01/08/2023
Certification Date: 01/08/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3880 CATALINA ST
TITUSVILLE FL
32796-2211
US

IV. Provider business mailing address

3880 CATALINA ST
TITUSVILLE FL
32796-2211
US

V. Phone/Fax

Practice location:
  • Phone: 321-346-8450
  • Fax: 321-249-1105
Mailing address:
  • Phone: 305-319-9527
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code252Y00000X
TaxonomyEarly Intervention Provider Agency
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code103K00000X
TaxonomyBehavior Analyst
License Number
License Number State

VIII. Authorized Official

Name: MS. SABRINA DE LA FE
Title or Position: EXECUTIVE DIRECTOR
Credential: MED, BCBA, ITDS
Phone: 786-499-4694