MEDICARE: NEST HAVEN ABA SERVICES 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	:	1346191210
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	NEST HAVEN ABA SERVICES LLC

Provider Business Mailing Address
First Line	:	10460 NW 8TH CT
Second Line	:
City	:	CORAL SPRINGS
State	:	FL
Zip	:	33071-5630
Country	:	US
Telephone Number	:	954-778-4478
Fax Number	:

Provider Business Practice Location Address
First Line	:	10460 NW 8TH CT
Second Line	:
City	:	CORAL SPRINGS
State	:	FL
Zip	:	33071-5630
Country	:	US
Telephone Number	:	954-778-4478
Fax Number	:

Authorized Official
Title or Position	:	OWNER
Name	:	SHANTE BRYAN
Credential	:
Telephone Number	:	954-778-4478

Provider Enumeration Date	:	02/06/2026
Last Update Date	:	02/06/2026

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