MEDICARE: CHILD ADVANCEMENT CENTER INC

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

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1326495029
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	CHILD ADVANCEMENT CENTER INC

Provider Business Mailing Address
First Line	:	101 S FEDERAL HWY
Second Line	:
City	:	DANIA BEACH
State	:	FL
Zip	:	33004-3622
Country	:	US
Telephone Number	:	305-833-8591
Fax Number	:	954-404-6522

Provider Business Practice Location Address
First Line	:	101 S FEDERAL HWY
Second Line	:
City	:	DANIA BEACH
State	:	FL
Zip	:	33004-3622
Country	:	US
Telephone Number	:	305-833-8591
Fax Number	:	954-404-6522

Authorized Official
Title or Position	:	PRESIDENT
Name	:	MR. CARLOS E BRAVO
Credential	:
Telephone Number	:	786-660-0350

Provider Enumeration Date	:	05/23/2016
Last Update Date	:	02/21/2024

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Directions to “CHILD ADVANCEMENT CENTER INC ” Practice Location

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