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General NPI Number Information
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NPI Number | 1932938156
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Entity Type | Organization
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Legal Business Name | RISE AND SHINE ABA SERVICES LLC
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Dates
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Enumeration Date | 07/26/2024
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Last Update Date | 07/26/2024
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Provider Practice Location Address
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Address Line | 122 W PINE ST STE 363
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City | ORLANDO
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State | FL
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Zip | 32801-2647
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Country | US
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Telephone | 305-834-5033
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Fax |
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Provider Business Mailing Address
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Address Line | 122 W PINE ST STE 363
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City | ORLANDO
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State | FL
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Zip | 32801-2647
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Country | US
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Telephone | 305-834-5033
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | NIKIFOROS PETRAKIS
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Credential |
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Telephone | 305-834-5033
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 106S00000X
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Taxonomy Name | Behavior Technician
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License Number |
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License Number State |
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