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General NPI Number Information
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NPI Number | 1982559282
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Entity Type | Organization
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Legal Business Name | COURAGEOUS HEARTS ABA
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Dates
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Enumeration Date | 03/02/2026
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Last Update Date | 03/02/2026
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Provider Practice Location Address
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Address Line | 110 E WAYNE ST FL 12
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City | FORT WAYNE
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State | IN
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Zip | 46802-2611
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Country | US
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Telephone | 845-535-9728
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Fax |
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Provider Business Mailing Address
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Address Line | 429 E DUPONT RD UNIT 2199
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City | FORT WAYNE
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State | IN
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Zip | 46825-2051
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | YITZCHAK RENZONI
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Credential |
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Telephone | 845-535-9728
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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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