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General NPI Number Information
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NPI Number | 1386017432
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Entity Type | Organization
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Legal Business Name | VIVBEHAVIOR ANALYSIS SERVICES,INC
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Dates
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Enumeration Date | 11/10/2015
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Last Update Date | 11/10/2015
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Provider Practice Location Address
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Address Line | 1801 NE 140TH ST APT 205
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City | NORTH MIAMI
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State | FL
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Zip | 33181-1313
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Country | US
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Telephone | 786-515-7166
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Fax |
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Provider Business Mailing Address
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Address Line | 1801 NE 140TH ST APT 205
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City | NORTH MIAMI
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State | FL
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Zip | 33181-1313
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Country | US
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Telephone | 786-515-7166
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Fax |
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Authorized Official
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Title or Position | BEHAVIOR ANALYST
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Name | VIVIAN CRUZ
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Credential | BCABA
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Telephone | 786-515-7166
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 320600000X
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Taxonomy Name | Intellectual and/or Developmental Disabilities Residential Treatment Facility
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License Number | 0-11-4185
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License Number State | FL
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