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General NPI Number Information
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NPI Number | 1295617363
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Entity Type | Organization
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Legal Business Name | ATLANTIC BEHAVIORAL HEALTH LLC
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Dates
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Enumeration Date | 07/21/2025
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Last Update Date | 02/05/2026
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Provider Practice Location Address
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Address Line | 11555 LAKE UNDERHILL RD
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City | ORLANDO
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State | FL
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Zip | 32825-5001
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Country | US
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Telephone | 630-631-9623
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Fax | 630-290-0522
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Provider Business Mailing Address
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Address Line | 124 KRAML DR
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City | BURR RIDGE
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State | IL
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Zip | 60527-0303
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Country | US
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Telephone | 630-631-9623
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Fax | 630-290-0522
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Authorized Official
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Title or Position | BCBA
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Name | MISS SHADEN KASSAR
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Credential | BCBA
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Telephone | 630-631-9623
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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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