Healthcare Provider Details
I. General information
NPI: 1811824519
Provider Name (Legal Business Name): SACRED ADULT SERVICES LLC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 05/06/2026
Last Update Date: 05/06/2026
Certification Date: 05/06/2026
Deactivation Date:
Reactivation Date:
III. Provider practice location address
5841 CORPORATE WAY STE 101
WEST PALM BEACH FL
33407-2039
US
IV. Provider business mailing address
5841 CORPORATE WAY STE 101
WEST PALM BEACH FL
33407-2039
US
V. Phone/Fax
- Phone: 561-328-8643
- Fax: 561-879-4977
- Phone: 561-328-8643
- Fax: 561-879-4977
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | N |
| Taxonomy Code | 103K00000X |
| Taxonomy | Behavior Analyst |
| License Number | |
| License Number State | |
| # 2 | |
| Primary Taxonomy | N |
| Taxonomy Code | 106S00000X |
| Taxonomy | Behavior Technician |
| License Number | |
| License Number State | |
| # 3 | |
| Primary Taxonomy | N |
| Taxonomy Code | 251C00000X |
| Taxonomy | Developmentally Disabled Services Day Training Agency |
| License Number | |
| License Number State | |
| # 4 | |
| Primary Taxonomy | N |
| Taxonomy Code | 261QA0600X |
| Taxonomy | Adult Day Care Clinic/Center |
| License Number | |
| License Number State | |
| # 5 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 373H00000X |
| Taxonomy | Day Training/Habilitation Specialist |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
ALEXANDER
YEPES
Title or Position: OWNER
Credential:
Phone: 786-285-6954