| NPI | 1205295094 |
|---|---|
| Former Legal Business Name | N/A |
| Entity Type | Organization |
| Authorized Contact | DAISY RAVELO President 954-394-2835 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 103K00000X Behavior Analyst (Licence: FL SW2625) |
| Additional Taxonomies | 252Y00000X Early Intervention Provider Agency (Licence: FL SW 2625) |
| 251V00000X Voluntary or Charitable (Licence: FL 59748) | |
| 305S00000X Point of Service (Licence: FL 59748) | |
| Enumeration Date | 2016-02-22 |
| Last Update Date | 2017-03-30 |