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General NPI Number Information
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NPI Number | 1003681677
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Entity Type | Organization
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Legal Business Name | HOMESTEAD ABA SERVICES LLC
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Dates
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Enumeration Date | 11/23/2023
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Last Update Date | 11/23/2023
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Provider Practice Location Address
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Address Line | 541 SE 34TH TER
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City | HOMESTEAD
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State | FL
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Zip | 33033-7494
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Country | US
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Telephone | 305-397-3815
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Fax |
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Provider Business Mailing Address
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Address Line | 541 SE 34TH TER
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City | HOMESTEAD
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State | FL
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Zip | 33033-7494
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | MBR
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Name | MARSHA P MUNROE
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Credential | BCBA
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Telephone | 305-397-3815
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 103K00000X
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Taxonomy Name | Behavior Analyst
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License Number |
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License Number State |
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