MEDICARE: RAISING HOPE BEHAVIORAL CENTER LLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	103K00000X	Behavior Analyst

General Provider Information

NPI Number	:	1245165810
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	RAISING HOPE BEHAVIORAL CENTER LLC

Provider Business Mailing Address
First Line	:	4699 N FEDERAL HWY STE 103F
Second Line	:
City	:	POMPANO BEACH
State	:	FL
Zip	:	33064-6510
Country	:	US
Telephone Number	:	786-226-2838
Fax Number	:

Provider Business Practice Location Address
First Line	:	4699 N FEDERAL HWY STE 103F
Second Line	:
City	:	POMPANO BEACH
State	:	FL
Zip	:	33064-6510
Country	:	US
Telephone Number	:	786-226-2838
Fax Number	:

Authorized Official
Title or Position	:	OWNER
Name	:	NORGE GONZALEZ
Credential	:	BCBA
Telephone Number	:	786-226-2838

Provider Enumeration Date	:	06/16/2026
Last Update Date	:	06/16/2026

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