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General NPI Number Information
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NPI Number | 1215337464
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Entity Type | Organization
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Legal Business Name | KIDS BEHAVIOR CENTER LLC
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Dates
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Enumeration Date | 08/25/2014
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Last Update Date | 10/10/2023
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Provider Practice Location Address
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Address Line | 14160 PALMETTO FRNTG ROAD SUITE #185
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City | MIAMI LAKES
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State | FL
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Zip | 33016
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Country | US
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Telephone | 786-442-7645
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Fax | 305-836-0574
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Provider Business Mailing Address
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Address Line | 8110 NW 159 TERRACE
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City | MIAMI LAKES
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State | FL
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Zip | 33016
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Country | US
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Telephone | 786-442-7645
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Fax | 305-836-0574
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Authorized Official
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Title or Position | PRESIDENT
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Name | MR. ARLEN JIMENEZ
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Credential |
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Telephone | 305-582-0341
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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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