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General NPI Number Information
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NPI Number | 1700426210
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Entity Type | Organization
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Legal Business Name | STANBACK ENTERPRISES LLC
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Dates
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Enumeration Date | 01/13/2020
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Last Update Date | 04/21/2025
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Provider Practice Location Address
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Address Line | 4701 N FEDERAL HWY STE 460
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City | POMPANO BEACH
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State | FL
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Zip | 33064-6591
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Country | US
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Telephone | 954-866-1430
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Fax |
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Provider Business Mailing Address
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Address Line | 4701 N FEDERAL HWY STE 460
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City | POMPANO BEACH
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State | FL
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Zip | 33064-6591
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Country | US
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Telephone | 954-866-1430
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | NIKEDA J STANBACK
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Credential |
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Telephone | 954-866-1430
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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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