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General NPI Number Information
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NPI Number | 1841187234
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Entity Type | Organization
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Legal Business Name | SUPPORTIVE ABA THERAPY CT LLC
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Dates
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Enumeration Date | 06/19/2025
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Last Update Date | 06/19/2025
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Provider Practice Location Address
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Address Line | 680 E MAIN ST
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City | STAMFORD
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State | CT
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Zip | 06901-2113
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Country | US
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Telephone | 855-316-2700
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Fax |
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Provider Business Mailing Address
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Address Line | 1810 N 52ND AVE
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City | HOLLYWOOD
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State | FL
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Zip | 33021-3912
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Country | US
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Telephone | 917-831-9691
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Fax |
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Authorized Official
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Title or Position | CEO
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Name | YOSEF TOLEDANO
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Credential |
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Telephone | 917-831-9691
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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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