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General NPI Number Information
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NPI Number | 1609638469
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Entity Type | Organization
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Legal Business Name | CASA DE ABA-BBM LLC
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Dates
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Enumeration Date | 01/26/2024
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Last Update Date | 01/26/2024
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Provider Practice Location Address
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Address Line | 9873 LAWRENCE RD APT E206
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City | BOYNTON BEACH
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State | FL
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Zip | 33436-3817
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Country | US
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Telephone | 754-258-7077
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Fax | 570-656-7575
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Provider Business Mailing Address
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Address Line | 9873 LAWRENCE RD APT E206
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City | BOYNTON BEACH
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State | FL
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Zip | 33436-3817
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Country | US
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Telephone | 754-258-7077
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Fax | 570-656-7575
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Authorized Official
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Title or Position | OWNER
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Name | TENESHA WEST
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Credential |
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Telephone | 754-258-7077
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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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