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General NPI Number Information
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NPI Number | 1114550316
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Entity Type | Organization
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Legal Business Name | LIZT LTM CENTER, INC
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Dates
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Enumeration Date | 02/15/2020
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Last Update Date | 01/18/2025
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Provider Practice Location Address
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Address Line | 9800 CARIBBEAN BLVD
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City | CUTLER BAY
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State | FL
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Zip | 33189-1521
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Country | US
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Telephone | 305-968-3011
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Fax |
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Provider Business Mailing Address
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Address Line | 100 NE 15TH ST STE 204
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City | HOMESTEAD
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State | FL
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Zip | 33030-4576
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Country | US
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Telephone | 305-968-3011
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Fax | 786-701-8538
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Authorized Official
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Title or Position | LEAD ANALYST
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Name | TAMARA COLLADO
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Credential | BCBA
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Telephone | 305-968-3011
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 106E00000X
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Taxonomy Name | Assistant Behavior Analyst
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 106S00000X
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Taxonomy Name | Behavior Technician
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License Number |
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License Number State |
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Taxonomy #3
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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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